日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
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TCR手術2週後の大量性器出血に対しUAEを施行した1例
石谷 健鈴木 志帆阿部 結貴劉 樺斎藤 史佳櫻井 理乃藏本 吾郎嶋田 悦子石川 聖子松井 英雄
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2011 年 27 巻 2 号 p. 461-463

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  A 37 year old woman, gravida 1, para 0 was referred to our department for persistent hypermenorrhea over the last two years. She had a 2 cm polypoid submucosal uterine leiomyoma. She took dienogest (2mg/d) for two weeks before transcervical resection (TCR), and we enucleated the leiomyoma with placental forceps. On postoperative day 14, after taking oral contraceptives for 10 days, she had sudden massive vaginal bleeding, and was brought back to our hospital. Since the arterial bleeding could not be controlled transvaginally, we performed blood transfusion and emergency transcatheter arterial embolization (UAE). After UAE, the patient had no further bleeding, and she resumed normal menstruation. It is possible to develop massive or delayed postoperative hemorrhage due to vessel injury after TCR, even if the myoma nodule is small. Careful attention should be paid during TCR procedures.
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© 2011 日本産科婦人科内視鏡学会
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