Uterine bleeding & artery...

A 44-year-old woman with no significant medical history had previously undergone an abdominal myomectomy for abnormal uterine bleeding and bulk-related symptoms approximately 14 years before current hospital admission. She reconsulted a gynaecologist owing to increasing symptoms from a multi leiomyomatous uterus that now reached her xiphoid process. Reluctant to undergo a hysterectomy, she opted for uterine artery embolization instead. During the uterine artery embolization, selective catheterization of both uterine arteries was achieved. A total of 12 vials of polyvinyl alcohol particles measuring 500–710 micrometres were administered. The patient presented to the emergency department 5 weeks later with a history of worsening anorexia, malaise, nausea, and dry cough since the procedure, as well as a 2-day history of vomiting with mild hematemesis, fever, chills, and significant abdominal pain localized to the uterus. An abdominal CT scan revealed a stable-in-size uterus containing multiple degenerating subserosal and intramural leiomyomas. All her cultures returned negative results, and, within only 8 hours of antibiotic initiation, both her fever and leucocytosis had resolved. However, on the fourth day of her admission, the patient developed an acute episode of dyspnoea and desaturation down to 76%, requiring a nonrebreather mask with 10 L of supplemental oxygen. A chest radiograph was taken.