Buttock necrosis and paraplegia after bilateral internal iliac artery embolization for postpartum hemorrhage.

Abstract

BACKGROUND:

Endovascular embolization has become part of the management of postpartum hemorrhage.

CASE:

We report a case of bilateral extensive gluteal skin and muscle necrosis with concurrent severe lumbosacral plexopathy after bilateral internal iliac artery embolization for postpartum hemorrhage. The ischemic plexopathy was treated conservatively, with a fair outcome. The complex gluteal wound was treated successfully with debridement and skin grafting.

CONCLUSION:

Pregnancy is known to increase the pelvic collateral blood vessels, and, hence, such a complication in a healthy pregnant woman is extremely rare. The risk of such a severe complication may be minimized by more selective embolization.

• Authors: Abdullah Al-Thunyan, Obaid Al-Meshal, Hanan Al-Hussainan, Mohammed H Al-Qahtani, Amel A F El-Sayed, Mohammad M Al-Qattan
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 120 Issue 2 Pt 2 Pg. 468-470 (Aug 2012) ISSN: 1873-233X [Electronic] United States
• PMID: 22825268 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Buttocks (pathology, surgery)
• Debridement
• Embolization, Therapeutic (adverse effects)
• Female
• Gelatin Sponge, Absorbable
• Humans
• Iliac Artery
• Magnetic Resonance Imaging
• Necrosis
• Paraplegia (diagnosis, etiology)
• Postpartum Hemorrhage (therapy)
• Pregnancy
• Sciatic Neuropathy (etiology)
• Treatment Outcome