Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report
Abstract Background Bladder flap hematoma (BFH) is a rare complication associated with cesarean section (CS). Its pathogenesis is linked to insufficient hemostasis and bleeding at the incision site, leading to the formation of a hematoma between the bladder and the lower uterine segment (LUS). To th...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07466-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850281721393577984 |
|---|---|
| author | Jiayi Zhang Guoliang Jiang Yiting Lu Chunyu Wang Zhenguo Qiao Juanjuan Yang |
| author_facet | Jiayi Zhang Guoliang Jiang Yiting Lu Chunyu Wang Zhenguo Qiao Juanjuan Yang |
| author_sort | Jiayi Zhang |
| collection | DOAJ |
| description | Abstract Background Bladder flap hematoma (BFH) is a rare complication associated with cesarean section (CS). Its pathogenesis is linked to insufficient hemostasis and bleeding at the incision site, leading to the formation of a hematoma between the bladder and the lower uterine segment (LUS). To the best of the authors’ knowledge, no specific protocols have been formulated to guide the treatment of BFH. Case presentation A 29-year-old woman underwent an emergency CS due to relative cephalopelvic disproportion. Twenty-two hours after the CS, she developed pale red hematuria accompanied with a significant decrease in hemoglobin. The patient experienced two fainting episodes after standing and engaging in activity, along with vaginal bleeding. A bedside ultrasound revealed a 50 mm fluid-filled sonolucent area between the lower uterine segment (LUS) and bladder. Subsequently, the patient received conservative treatment with internal iliac artery embolization, antibiotics and blood transfusion, to avoid secondary laparotomy. The angiography and computer tomography examinations revealed the existence of uterine artery pseudoaneurysm and a large BFH. Her vital signs remained stable after the intervention and repeat ultrasonography demonstrated a significant reduction in the hematoma size. Conclusions Selective pelvic artery embolization as a conservative treatment can be a safe and effective option for large BFH, provided the patient remains clinically stable. This interventional therapy presents an innovative, non-surgical approach to a condition that is typically treated surgically and may carry the risk of irreparable complications. |
| format | Article |
| id | doaj-art-e44672d557674c87896583bcc75ee69f |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-e44672d557674c87896583bcc75ee69f2025-08-20T01:48:11ZengBMCBMC Pregnancy and Childbirth1471-23932025-03-012511910.1186/s12884-025-07466-7Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case reportJiayi Zhang0Guoliang Jiang1Yiting Lu2Chunyu Wang3Zhenguo Qiao4Juanjuan Yang5Department of Obstetrics, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to, Soochow UniversityaqDepartment of Obstetrics, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to, Soochow UniversityaqDepartment of Obstetrics, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to, Soochow UniversityaqDepartment of Obstetrics, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to, Soochow UniversityaqDepartment of Gastroenterology, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to Soochow UniversityDepartment of Obstetrics, Suzhou Ninth People’s Hospital, Suzhou Ninth Hospital Affiliated to, Soochow UniversityaqAbstract Background Bladder flap hematoma (BFH) is a rare complication associated with cesarean section (CS). Its pathogenesis is linked to insufficient hemostasis and bleeding at the incision site, leading to the formation of a hematoma between the bladder and the lower uterine segment (LUS). To the best of the authors’ knowledge, no specific protocols have been formulated to guide the treatment of BFH. Case presentation A 29-year-old woman underwent an emergency CS due to relative cephalopelvic disproportion. Twenty-two hours after the CS, she developed pale red hematuria accompanied with a significant decrease in hemoglobin. The patient experienced two fainting episodes after standing and engaging in activity, along with vaginal bleeding. A bedside ultrasound revealed a 50 mm fluid-filled sonolucent area between the lower uterine segment (LUS) and bladder. Subsequently, the patient received conservative treatment with internal iliac artery embolization, antibiotics and blood transfusion, to avoid secondary laparotomy. The angiography and computer tomography examinations revealed the existence of uterine artery pseudoaneurysm and a large BFH. Her vital signs remained stable after the intervention and repeat ultrasonography demonstrated a significant reduction in the hematoma size. Conclusions Selective pelvic artery embolization as a conservative treatment can be a safe and effective option for large BFH, provided the patient remains clinically stable. This interventional therapy presents an innovative, non-surgical approach to a condition that is typically treated surgically and may carry the risk of irreparable complications.https://doi.org/10.1186/s12884-025-07466-7Bladder flap hematomaPseudoaneurysmCesarean sectionArtery embolizationConservative treatmentCase report |
| spellingShingle | Jiayi Zhang Guoliang Jiang Yiting Lu Chunyu Wang Zhenguo Qiao Juanjuan Yang Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report BMC Pregnancy and Childbirth Bladder flap hematoma Pseudoaneurysm Cesarean section Artery embolization Conservative treatment Case report |
| title | Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report |
| title_full | Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report |
| title_fullStr | Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report |
| title_full_unstemmed | Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report |
| title_short | Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report |
| title_sort | conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization a case report |
| topic | Bladder flap hematoma Pseudoaneurysm Cesarean section Artery embolization Conservative treatment Case report |
| url | https://doi.org/10.1186/s12884-025-07466-7 |
| work_keys_str_mv | AT jiayizhang conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport AT guoliangjiang conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport AT yitinglu conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport AT chunyuwang conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport AT zhenguoqiao conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport AT juanjuanyang conservativetreatmentofbladderflaphematomacomplicatedwithuterinearterypseudoaneurysmaftercesareansectionviainternaliliacarteryembolizationacasereport |