case_images: PMC10693466_01
case_images: Transvaginal ultrasonographic images. (a) The left image shows the B-mode scan, and the right image shows color Doppler scan. To the left of the uterus, a 1.7 x 1.6 cm low-echoic mass is observed with turbulent flow inside it. (b) An 8 cm sized hematoma is observed in the pelvis.
case_images: CRIOG2023-1637463.001.jpg
case_images: PMC10693466_01_CRIOG2023-1637463.001.jpg
case_images: fig1
case_images: Transvaginal ultrasonography revealed a 17.6 x 16.7 mm hypoechoic mass adjacent to the left cervicocorporeal junction within an 8 cm hematoma (Figure 1). The mass had a turbulent swirling flow inside it, suggestive of an exophytic UAP with hemoperitoneum (Figure 1).
case_images: Contrast-enhanced computed tomographic images: (a) axial image and (b) sagittal image. The pseudoaneurysm, which originates from the left uterine artery, is outside of the uterine cavity. Hemoperitoneum is also observed. The arrowhead indicates the pseudoaneurysm. The arrow indicates the uterus.
case_images: CRIOG2023-1637463.002.jpg
case_images: PMC10693466_01_CRIOG2023-1637463.002.jpg
case_images: fig2
case_images: Contrast-enhanced computed tomography showed a pseudoaneurysm outside of the uterine cavity that originated from the left uterine artery with contrast extravasation and hemoperitoneum, confirming the diagnosis of a ruptured exophytic UAP (Figure 2).
case_images: Angiographic images. (a) An angiogram reveals a pseudoaneurysm located at the level of the left uterine artery bifurcation. The asterisk indicates the uterine artery pseudoaneurysm. The arrow indicates the ascending branch. The arrowhead indicates the descending branch. (b) The uterine artery pseudoaneurysm with contrast extravasation is shown. The arrowheads indicate contrast extravasation. (c) Postembolization is completed with n-butyl-2-cyanoacrylate and coils.
case_images: CRIOG2023-1637463.003.jpg
case_images: PMC10693466_01_CRIOG2023-1637463.003.jpg
case_images: fig3
case_images: Selective left iliac angiography performed via the right femoral artery revealed a pseudoaneurysm located at the level of the left uterine artery bifurcation into the ascending and descending branches with contrast extravasation (Figure 3). Embolization was achieved using n-butyl-2-cyanoacrylate (NBCA) and coils (Figure 3).
case_images: Magnetic resonance image on day two after embolization. Axial T2-weighted magnetic resonance image shows a hematoma within the broad ligament (arrow) adjacent to the postpartum uterus (asterisk) and hemoperitoneum (arrowhead). A continuous hematoma is observed from the thrombosed uterine artery pseudoaneurysm to the abdominal cavity, suggesting laceration of the left broad ligament (dotted circle).
case_images: CRIOG2023-1637463.004.jpg
case_images: PMC10693466_01_CRIOG2023-1637463.004.jpg
case_images: fig4
case_images: Two days after embolization, magnetic resonance imaging revealed a continuous hematoma from the thrombosed UAP to the abdominal cavity, suggesting a laceration on the leaflet of the left broad ligament (Figure 4).