Large Retroperitoneal Hematoma: A Rare Intraoperative Complication of Total Vaginal Hysterectomy
| Autor: | Xuezhi Jiang, Abigail Coots, Kirthik Nathan Parthasarathy, Anna Fuchs, Nikunj R. Chauhan |
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| Rok vydání: | 2021 |
| Předmět: |
retroperitoneal hematoma
medicine.medical_specialty Aortography Intraoperative Complication medicine.medical_treatment Uterosacral ligament Trauma intraoperative hemodynamic instability Bilateral Salpingectomy surgical complication gynecologic surgery Hematoma medicine total vaginal hysterectomy Hysterectomy medicine.diagnostic_test business.industry General Engineering Cystoscopy medicine.disease Surgery medicine.anatomical_structure abnormal uterine bleeding Endometrial ablation Obstetrics/Gynecology business |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.16760 |
| Popis: | Retroperitoneal (RP) hematoma is a rare complication of total vaginal hysterectomy. A 45-year-old female G4P3013 with a history of abnormal uterine bleeding refractory to treatment by endometrial ablation and stress urinary incontinence underwent total vaginal hysterectomy, bilateral salpingectomy, bilateral uterosacral ligament suspension, anterior colporrhaphy, and cystoscopy. After the hysterectomy the left uterine artery pedicle was hemostatic; however, the patient became hemodynamically unstable and anemic. Laparoscopy revealed a stable zone III RP hematoma. Intraoperative observation revealed no further expansion of the hematoma. Left iliac angiography and aortography revealed there was no extravasation from the uterine arteries and gonadal vessels. Four days post-operative abdominal CT showed a stable hematoma. Hemodynamic instability resolved over the post-operative course. RP hematoma must be included in the differential for the evaluation of acute intraoperative hemodynamic instability with an unclear source. |
| Databáze: | OpenAIRE |
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