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

• Hwang DW
• Song HS
• Kim HS
• Chun KC
• Koh JW
• Kim YA

• KMID: 2393852
• DOI: http://doi.org/10.5468/ogs.2017.60.5.490

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.

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