Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

Abstract

Leiomyomas, also termed as fibroids, are benign smooth, muscle neoplasms seen in 70–80% of women by the age of 50 years. Uterine artery embolization (UAE) is a minimally invasive procedure that involves cessation of vascular supply to the fibroids, by infusion of gelatinous microspheres into the uterine arteries. Pyomyoma is a suppurative leiomyoma, secondary to infection of necrotic tissue. It is an infrequent complication of uterine artery embolization (UAE). Pyomyoma can lead to sepsis, peritonitis, and respiratory distress syndrome resulting in high morbidity and mortality. Due to its rarity, high suspicion is crucial in the diagnosis, and prompt treatment is recommended to reduce mortality. Ultrasound, computed tomography, and magnetic resonance imaging assist in diagnosis. We present a case of a 44-year-old woman with ruptured pyomyoma, following an UAE intervention. The patient was treated with total abdominal hysterectomy and salpingo-oophorectomy along with peritoneal irrigation and drainage.