Laparoscopic Internal Iliac Artery Ligation for Postpartum Spontaneous Hemoperitoneum

Lu Gao J, Jennifer Lu Gao, Lortie K, Karine Lortie, Sukhbir S. Singh, Singh SS, Sukhbir Sony Singh
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2010 · vol. 32(12) , pp. 1172–1175 · doi:10.1016/s1701-2163(16)34742-9 · PMID:21176330 · W2097601299
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This paper describes the successful use of laparoscopic internal iliac artery ligation to manage postpartum spontaneous hemoperitoneum in a single patient.

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Abstract

BackgroundSpontaneous hemoperitoneum in pregnancy or the postpartum period is an uncommon but potentially life-threatening complication.CaseA 29-year-old woman presented with severe abdominal pain, decreased consciousness, and a reduced hemoglobin level three days after an uneventful spontaneous vaginal delivery. Initial ultrasound and CT imaging showed significant hemoperitoneum with no identifiable cause. Laparoscopic surgery was performed, during which bleeding from the left uterine artery was identified and resolved with laparoscopic internal iliac artery ligation. Concomitant cul-de-sac obliteration and adhesions secondary to decidualized endometriosis were found.ConclusionDecidualized endometriosis is a possible etiologic factor in spontaneous hemoperitoneum. Prompt diagnosis and treatment are critical for improving outcomes. When surgical intervention is indicated, a laparoscopic approach should be considered because of its minimally invasive nature and shorter recovery time.

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Condition tags

endometriosis

MeSH descriptors

Hemoperitoneum Hemoperitoneum Iliac Artery Laparoscopy Pregnancy Complications, Cardiovascular Pregnancy Complications, Cardiovascular Adult Douglas' Pouch Douglas' Pouch Endometriosis Endometriosis Endometriosis Female Hemoperitoneum Hemoperitoneum Humans Iliac Artery Ligation Peritoneal Diseases Peritoneal Diseases

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