Pyomyoma after uterine artery embolization: A case report

BACKGROUND: Uterine pyomyoma is a rare complication of uterine artery embolization (UAE), and causes significant morbidity and mortality. This report describes the diagnosis and prompt management of this condition. CASE: A 48-year-old woman presented with fever, chills, and diffuse abdominal pain 15 days after undergoing UAE for symptomatic fibroids. Computed tomography showed the uterus to be significantly distended, with multiple intra-cavitary masses containing a large amount of gas and air–fluid level. Sepsis secondary to post-UAE pyomyoma was suspected. Hemodynamic resuscitation and broad-spectrum antibiotics were immediately started. The patient underwent emergency exploratory laparotomy with total hysterectomy. CONCLUSION: In order to ensure appropriate and timely intervention, the diagnosis of uterine pyomyoma should be considered in patients presenting with signs of infection and abdominal pain after UAE.