[Inferior Mesenteric Artery Embolization with N-Butyl Cyanoacrylate for Life-Threatening Postpartum Hemorrhage: A Report of Two Cases and Literature Review].

The inferior mesenteric artery is a rare source of postpartum hemorrhage. We report two cases of primary postpartum hemorrhage that originated from the inferior mesenteric artery after vaginal delivery. Both patients showed signs of hypovolemic shock, and disseminated intravascular coagulation was suspected. The bleeding continued even after embolization of the uterine artery, a typical source of postpartum hemorrhage. Inferior mesenteric arteriography confirmed contrast extravasation from the superior rectal artery, and selective embolization was performed using N-butyl cyanoacrylate. This report highlights that the inferior mesenteric artery can be a source of bleeding in patients with intractable and persistent postpartum hemorrhage due to birth canal injury.

[1]  H. Ishimoto,et al.  Retained Products of Conception Fed by the Inferior Mesenteric Artery: A Case Report. , 2020, The Tokai journal of experimental and clinical medicine.

[2]  H. Yoon,et al.  Inferior mesenteric artery embolization for persistent postpartum hemorrhage after sufficient bilateral iliac arteries embolization: safety and efficacy in eight patients. , 2019, The British journal of radiology.

[3]  B. Kim,et al.  Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate , 2019, Journal of the Korean Society of Radiology.

[4]  J. Shin,et al.  Postpartum haemorrhage due to genital tract injury after vaginal delivery: safety and efficacy of transcatheter arterial embolisation , 2018, European Radiology.

[5]  F. Kung,et al.  Transcatheter arterial embolization as first-line rescue in intractable primary postpartum hemorrhage: Assessment, outcome, and subsequent fertility. , 2017, Journal of the Formosan Medical Association = Taiwan yi zhi.

[6]  S. Lee,et al.  Embolization of Inferior Mesenteric Artery for Intractable Intrapelvic and Vaginal Bleeding After Hysterectomy. , 2016, Journal of minimally invasive gynecology.

[7]  T. Abe,et al.  Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration , 2016, CardioVascular and Interventional Radiology.

[8]  S. Standring Gray's Anatomy: The Anatomical Basis of Clinical Practice , 2015 .

[9]  G. Lieberman,et al.  Uterine artery embolization. , 2012, Clinical privilege white paper.

[10]  N. Kawai,et al.  Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition. , 2009, Journal of vascular and interventional radiology : JVIR.