Pyomoyoma is a rare
complication of Uterine Artery Embolization (UAE). This case report reflects on
this condition. A 45-year-old female, a known case of adenomyosis, presented with intermittent fever and foul
vaginal discharge. These symptoms occurred shortly after the patient underwent
UAE for menorrhagia secondary to adenomyosis. Computed tomography scan of the
abdomen and pelvis aided in the diagnosis of Pyomyoma secondary to UAE. After a
trial of broad spectrum antibiotics and Suction and Evacuation of the uterus
had little to no help in the patient’s condition, she underwent Total Abdominal
Hysterectomy in which a big, organized pus collection was removed from the
uterus. Conclusion: Pyomyoma should be considered in the differentials for
patients presenting with fever and vaginal discharge post UAE.
References
[1]
Vannuccini, S. and Petraglia, F. (2019) Recent Advances in Understanding and Managing Adenomyosis. F1000Research, 8, 283.
https://doi.org/10.12688/f1000research.17242.1
[2]
Mason, T.C., Adair, J. and Lee, Y.C. (2005) Postpartum Pyomyoma. Journal of the National Medical Association, 97, 826-828.
[3]
Yu, Q., Gabriel, G., Hoffman, M., Sanampudi, S., Jassim, T. and Raissi, D. (2019) Uterine-Sparing Management of Pyomyoma after Uterine Fibroid Embolization. Radiology Case Reports, 14, 1031-1035. https://doi.org/10.1016/j.radcr.2019.05.009
[4]
Rosen, M.L., Anderson, M.L. and Hawkins, S.M. (2013) Pyomyoma after Uterine Artery Embolization. Obstetrics & Gynecology, 121, 431-433.
https://doi.org/10.1097/AOG.0b013e31827e8e8f
[5]
Schirf, B.E., Vogelzang, R.L. and Chrisman, H.B. (2006) Complications of Uterine Fibroid Embolization. Seminars in Interventional Radiology, 23, 143-149.
https://doi.org/10.1055/s-2006-941444
[6]
Rezai, S. (2016) Pyomyoma Following Uterine Artery Embolization (UAE)-Dual Case Report and Review of Literature. International Journal of Gynecology & Obstetrics, 4, 9-13. https://doi.org/10.15406/ogij.2016.04.00097
[7]
Yuan, K., Zhang, J.L., Yan, J.Y., Yuan, B., Fu, J.X., Wang, Y., et al. (2021) Uterine Artery Embolization with Small-Sized Particles for the Treatment of Symptomatic Adenomyosis: A 42-Month Clinical Follow-Up. International Journal of General Medicine, 14, 3575-3581. https://doi.org/10.2147/IJGM.S312618
[8]
Pinto, E., Trovão, A., Leitão, S., Pina, C., Mak, F.K. and Lanhoso, A. (2012) Conservative Laparoscopic Approach to a Perforated Pyomyoma after Uterine Artery Embolization. Journal of Minimally Invasive Gynecology, 19, 775-779.
https://doi.org/10.1016/j.jmig.2012.07.001
[9]
DeMaio, A. and Doyle, M. (2015) Pyomyoma as a Rare Source of Postpartum Sepsis. Case Reports in Obstetrics and Gynecology, 2015, 263518.
https://doi.org/10.1155/2015/263518
[10]
Verma, S.K., Gonsalves, C.F., Baltarowich, O.H., Mitche, D.G., Lev-Toaff, A.S. and Bergin, D. (2010) Spectrum of Imaging Findings on MRI and CT after Uterine Artery Embolization. Abdominal Radiology, 35, 118-128.
https://doi.org/10.1007/s00261-008-9483-6
[11]
Ezzedine, D., Ndubizu, C., Kayani, S. and David, A. (2020) Pyomyoma after Uterine Artery Embolization: A Case Report. Case Reports in Women’s Health, 26, 3-5.
https://doi.org/10.1016/j.crwh.2020.e00186
