Obstet Gynecol Sci.  2017 Sep;60(5):490-493. 10.5468/ogs.2017.60.5.490.

Delayed intestinal perforation and vertebral osteomyelitis after high-intensity focused ultrasound treatment for uterine leiomyoma

Affiliations
  • 1Department of Obstetrics and Gynecology, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea. camanbal@paik.ac.kr

Abstract

High-intensity focused ultrasound (HIFU) is a non-invasive uterine fibroid treatment option for patients who want to preserve fertility. However, according to several reports regarding ablation of solid tumors by HIFU, there are rare complications in patients with uterine leiomyomas, and overall data are still insufficient. Here, we report rare and major complications of HIFU, such as delayed intestinal perforation, uterine perforation with recto-uterine fistula, and osteomyelitis 29 days after the HIFU procedure to treat multiple myomas. Thus, we present a very serious case resulting from HIFU treatment of uterine fibroids and a review of the literature.

Keyword

High-intensity focused ultrasound; Uterine leiomyoma; Delayed intestinal perforation; Osteomyelitis

MeSH Terms

Fertility
Fistula
Humans
Intestinal Perforation*
Leiomyoma*
Myoma
Osteomyelitis*
Ultrasonography*
Uterine Perforation

Figure

  • Fig. 1 (A) Transvaginal sonography: fluid collection around uterus (red arrow). (B, C) Air-fluid level of anterior abdominal wall (white arrow) in abdomen-pelvic computed tomography (CT): air-density of L5 (B) and S1 (C) level of vertebra (red-circle).

  • Fig. 2 (A) 1.5-cm sized perforation of the colon (blue circle) was found approximately 10 cm above the anal verge. (B) Subtotal abdominal hysterectomy and left salpingo-oophorectomy.


Cited by  3 articles

Complication Following Ultrasound-Guided High-Intensity Focused Ultrasound for the Treatment of Uterine Adenomyosis: Case Report of CT Imaging Features
Sang Hyup Hong, Gil-Sun Hong, Choong Wook Lee, Gi Hong Kim
J Korean Soc Radiol. 2019;80(3):579-584.    doi: 10.3348/jksr.2019.80.3.579.

Comment on: Delayed intestinal perforation and vertebral osteomyelitis after high-intensity focused ultrasound treatment for uterine leiomyoma
Jennifer K.Y. Ko, Vincent Y.T. Cheung
Obstet Gynecol Sci. 2018;61(2):177-178.    doi: 10.5468/ogs.2018.61.2.177.

Reconstruction of an abdominal wall defect using a latissimus dorsi musculocutaneous free flap after high-intensity focused ultrasound: a case report
Dae Kwan Kim, Youn Hwan Kim
Arch Hand Microsurg. 2023;28(2):110-113.    doi: 10.12790/ahm.23.0008.


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