{"title":"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。","authors":"Mami Shibahara, Emi Kondo, Eiji Shibata, Satoshi Fukumitsu, Kenta Anai, Shigeto Ishikawa, Yoshiko Hayashida, Masaru Araki, Kiyoshi Yoshino","doi":"10.1186/s13256-024-04871-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"18 1","pages":"553"},"PeriodicalIF":0.9000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566897/pdf/","citationCount":"0","resultStr":"{\"title\":\"Spontaneous rupture of an ovarian artery aneurysm complicated by postpartum hypertensive disorders of pregnancy after caesarean section: a case report and literature review.\",\"authors\":\"Mami Shibahara, Emi Kondo, Eiji Shibata, Satoshi Fukumitsu, Kenta Anai, Shigeto Ishikawa, Yoshiko Hayashida, Masaru Araki, Kiyoshi Yoshino\",\"doi\":\"10.1186/s13256-024-04871-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16236,\"journal\":{\"name\":\"Journal of Medical Case Reports\",\"volume\":\"18 1\",\"pages\":\"553\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566897/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s13256-024-04871-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13256-024-04871-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.
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