Fatal septicaemia after fibroid embolization
- Created: October 8, 1999
- by: admin
By: Bruce McLucas, Scott C. Goodwin, Louis Adler, Richard Reed THE LANCET
November 1999 Volume 354 No. 9191 pp. 1730
Sir-Arvind Vashisht and colleagues report a mortality related to UFE. Our group in Los Angeles has done this procedure in 367 women with menorrhagia associated with uterine fibroids since 1996. Among these women there have been no deaths. Two patients did develop infections after UFE, requiring hysterectomy. We noted in Vashisht and colleagues report that the patient with a 20-week-sized uterus was embolised with 300 um polyvinyl alcohol (PVA). Some members of our group have used 700 um PVA particles in large uteri (>2500 mL) since the last infection in 1998. We have had no further infections.
Post-embolisation syndrome is a well documented disorder that occurs in many parts of the body after embolisation. Nonetheless, clinicians must be vigilant for any sign of infection after embolisation. In our practice, we obtain blood cultures as well as computed tomography scans of the peIvis. An abscess is clear on such imaging, and requires surgical treatment.
Morbidity has been lower in our group of patients than in patients undergoing surgical correction. We would hope that with better understanding, mortality such as the case reported could be avoided.
Bruce McLucas, Scott C Goodwin, Louis Adler, Richard Reed
*Obstetrics and Gynecology, UCLA Medical Group, Los Angeles, CA 90095, USA Century City Hospital, Los Angeles, CA and Daniel Freeman Memorial Hospital, Inglewood, CA
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