Pyomyoma After Uterine Artery Embolization: Laparotomy Avoided by In-Bag Morcellation

J Minim Invasive Gynecol. 2019 Jan;26(1):175-177. doi: 10.1016/j.jmig.2018.07.022. Epub 2018 Aug 9.

Abstract

We report a case of a pyomyoma in which in-bag morcellation allowed for a total laparoscopic hysterectomy instead of laparotomy, which has been recognized as the standard of care to avoid the spread of infection from morcellation. A 45-year-old multiparous woman presented with sepsis, pelvic pain, and leukocytosis at 1 month after undergoing uterine artery embolization for symptomatic uterine leiomyoma. Pelvic computed tomography scan revealed a 9-cm suspected pyomyoma. A total hysterectomy was performed using a laparoscopic approach with in-bag morcellation. The intervention was successful, and the postoperative course was uneventful. The patient was discharged on postoperative day 1 and was well at 2 months after surgery.

Keywords: In-bag morcellation; Laparoscopy; Pyomyoma; Uterine artery embolization.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Hysterectomy / methods
  • Laparoscopy / methods
  • Laparotomy
  • Leiomyoma / surgery*
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Morcellation / methods*
  • Postoperative Complications
  • Uterine Artery Embolization / methods*
  • Uterine Neoplasms / surgery*