Uterine necrosis

A complication rate of 8.7% was reported in the literature [56-59]. This includes contrast-induced, puncture and embolization related complications. The reported complications related to the embolization include foot ischemia, bladder necrosis, rectal wall necrosis, nerve injury and uterine necrosis. These complications are caused by non-targeted vessel embolization. 

Cottier JP, Fignon A, Tranquart F, Herbreteau D (2002) Uterine necrosis after arterial embolization for postpartum hemorrhage. Obstet Gynecol 100 1074-1077... 

Godfrey CD,Zbella EA (2001) Uterine necrosis after uterine artery embolization for leiomyoma. Obstet Gynecol 98 950-952... 

Gabriel H, Pinto CM, Kumar M et al. (2004) MRl detection of uterine necrosis after uterine artery embolization for fibroids. Am J Roentgenol 183 733-736... 

Torigian DA, Siegelman ES, Terhune KP, Butts SF, Blasco L, Shlansky-Goldberg RD (2005) MRI of uterine necrosis after uterine artery embolization for treatment of uterine leiomyomata. AJR Am J Roentgenol 184 555-559... 

Ovarian vein thrombosis typically presents a complication in the postpartum period and is encountered most frequently after caesarean section. It is caused by venous stasis and hypercoagulability. The incidence of puerperal vein thrombosis (POVT) is approximately 1 in 2,000 deliveries [33]. Other conditions such as infection, recent surgery, malignancy, and Crohn disease increase the risk for ovarian vein thrombosis [34]. Although a rare entity, ovarian vein thrombosis presents a differential diagnostic problem because of the unspecific clinical symptoms, including fever, and the potential of fatal complications due to uterine necrosis... 

The principal adverse reaction to warfarin is hemorrhage. Prolonged therapy with the coumarin-type anticoagulants is relatively free of untoward effects. Bleeding may be observable (e.g., skin, mucous membranes) or occult (e.g., gastrointestinal, renal, cerebral, hepatic, uterine, or pulmonary). Rarer untoward effects include diarrhea, small intestine necrosis, urticaria, alopecia, skin necrosis, purple toes, and dermatitis. 

When used in high doses for long periods to treat life-threatening conditions, e.g. SIRS, it may result in peripheral ischaemia or even gangrene. Extravascular leakage my result in skin necrosis. If used in late pregnancy it may induce uterine contractions and/or reduce placental blood flow. 

Surface Properties of lUDs. Most lUDs currently in use cause only minimum changes in the uterine endometrium (19). Excessive menstrual bleeding, intermenstrual spotting, and bleeding between menstrual periods have been noted as sources of annoyance, and they constitute a major reason for removal of lUDs. Such bleeding is probably secondary to local hyperemia, edema, pressure necrosis, and sometimes endometritis (20). After lUDs are inserted into the uterus, some patients complain of pain and low backache, but pain is a minor reason for discontinuing intrauterine contraception. 

Dilute solutions of 1-10% formalin have been instilled into the bladder to treat inoperable profusely bleeding tumors or intractable hemorrhagic cystitis. Anuria was a severe complication. This was due either to edematous obstruction of the ureter or to tubular or papillary necrosis, probably caused by systemic absorption. Bladder perforation with intraperitoneal spillage, peritonitis, and finally death was described in an elderly patient with a carcinoma of the uterine cervix (SEDA-11, 476). 

Indications Damp heat jaundice. Acute hepatitis, hepatic necrosis, cirrhosis, cholecystitis, cholelithiasis, favism, malarial diseases, typhoid fever, leukemia, leptospirosis, nephritis, edema, beriberi, stomatitis, urticaria, pruritus, gingivitis, eye diseases, and uterine bleeding... 

There have been complications reported in association with the use of trisacryl gelatin microspheres. De Blok et al. reported a case of fatal sepsis after uterine artery embolization performed with this agent. In this case, diffuse necrosis of the vaginal wall and cervix was found, attributed to distal penetration of spheres measuring 500-700 p in diameter... 

Porcu G, Roger V, Jacquier A et al. (2005) Uterus and bladder necrosis after uterine artery embolisation for postpartum haemorrhage. BJOG 112 122-123... 

Yeagley TJ, Goldherg J et al (2002) Labial necrosis after uterine artery embolization for leiomyomata. Obstet Gynecol 100 881-882... 

E1-Shalakany AH, Nasr El-Din MH, Wafa GA, Azzam ME, El-Dorry A (2003) Massive vault necrosis with bladder fistula after uterine artery embolisation. Bjog 110 215-216... 

Lowenstein L, Soft 1, Siegler E, RazN, Amit A (2004) Focal cervical and vaginal necrosis following uterine artery embolisation. Eur J Obstet Gynecol Reprod Biol 116 250-251... 

Dietz DM, Stahlfeld KR, Bansal SK, Christopherson WA (2004) Buttock necrosis after uterine artery embolization. Obstet Gynecol 104 1159-1161... 

Bilateral occlusion of the uterine arteries during uterine artery embolization clearly increases the risk of global uterine ischemia and subsequent infarction in patients undergoing this procedure [10]. In fact, it is not unreasonable to assume that uterine ischemia occurs in all patients undergoing this procedure and that this ischemia likely contributes to the post-procedure pain that is commonly experienced by most patients after embolization. However, rarely this transient ischemia worsens to the point where the uterus becomes globally infarcted. There have been reports of diffuse uterine ischemia and necrosis after uterine artery embolization [84, 85]. The typical presentation of uterine ischemia consists of long-standing pelvic pain which persists for several weeks associated... 

Sabatini L, Atiomo W, Magos A (2003) Successbil myomectomy following infected ischaemic necrosis of uterine fibroids after uterine artery embobsation. Br J Obstet Gynaecol 110 704-710... 

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