剖腹产后并发产后妊娠高血压疾病的卵巢动脉瘤自发性破裂:病例报告和文献综述。

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Medical Case Reports Pub Date : 2024-11-15 DOI:10.1186/s13256-024-04871-y
Mami Shibahara, Emi Kondo, Eiji Shibata, Satoshi Fukumitsu, Kenta Anai, Shigeto Ishikawa, Yoshiko Hayashida, Masaru Araki, Kiyoshi Yoshino
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引用次数: 0

摘要

背景:围产期动脉瘤自发破裂被认为是与妊娠和分娩引起的生理变化有关的严重并发症。卵巢动脉瘤破裂非常罕见,会导致腹膜后快速出血。在此,我们报告了一例剖腹产后卵巢动脉瘤自发性破裂导致的产后妊娠高血压疾病并发腹膜后腔大量出血的病例,并回顾了以往的文献:一名 41 岁的日本妇女在剖腹产四天后因失血性休克伴腹部和右翼疼痛被转诊至我院。对比增强计算机断层扫描显示腹膜后巨大血肿。血管造影显示右卵巢动脉瘤破裂,与扩张的子宫动脉吻合。她成功地接受了经导管动脉栓塞治疗。栓塞术后 3 天,她被诊断为产后妊娠高血压疾病:结论:卵巢动脉瘤破裂可能发生在围产期,但产科医生对此还没有广泛的认识。多胎妊娠和妊娠高血压可能是卵巢动脉瘤破裂的危险因素。早期诊断和治疗,如经导管动脉栓塞术,为紧急开腹手术做准备,对治疗这种致命疾病至关重要。
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Spontaneous rupture of an ovarian artery aneurysm complicated by postpartum hypertensive disorders of pregnancy after caesarean section: a case report and literature review.

Background: The spontaneous rupture of an artery aneurysm during the perinatal period is considered a serious complication associated with the physiological alteration by pregnancy and delivery. The rupture of an ovarian artery aneurysm is rare and leads to rapid retroperitoneal hemorrhage. Here, we report one case complicated by postpartum hypertensive disorder of pregnancy associated with massive bleeding into retroperitoneal cavity by the spontaneous rupture of ovarian artery aneurysm after caesarean section, and reviewed previous literature.

Case presentation: A 41-year-old Japanese woman was referred to our hospital four days after undergoing cesarean delivery because of hemorrhagic shock with abdominal and right flank pain. Contrast-enhanced computed tomography revealed a large retroperitoneal hematoma. Angiography showed a ruptured right ovarian artery aneurysm, anastomosing with a dilated uterine artery. She was successfully treated with transcatheter arterial embolization. She was diagnosed with postpartum hypertensive disorder of pregnancy 3 days after the embolization.

Conclusion: The rupture of ovarian aneurysm can occur during the perinatal period, although it has not been widely understood among obstetricians. Multiparity and hypertensive disorder of pregnancy might be risk factors for the rupture of an ovarian aneurysm. Early diagnosis and therapy, such as transcatheter arterial embolization in preparation for an emergency laparotomy, are crucially important for the management of this fatal disease.

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来源期刊
Journal of Medical Case Reports
Journal of Medical Case Reports Medicine-Medicine (all)
CiteScore
1.50
自引率
0.00%
发文量
436
期刊介绍: JMCR is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: 1. Unreported or unusual side effects or adverse interactions involving medications 2. Unexpected or unusual presentations of a disease 3. New associations or variations in disease processes 4. Presentations, diagnoses and/or management of new and emerging diseases 5. An unexpected association between diseases or symptoms 6. An unexpected event in the course of observing or treating a patient 7. Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
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