Septic Complications Following Uterine Artery Embolization: A Case Report of Necrotic Degenerative Fibroid and Successful Surgical Management

Abstract This case report presents a 33-year-old woman who developed pyomyoma complicated by sepsis six weeks following uterine artery embolization (UAE) for symptomatic fibroids. The initial postoperative period was uneventful; however she developed pelvic discomfort progressed over weeks to severe lower abdominal pain, high-grade fever, and offensive vaginal discharge. Imaging revealed necrotic fibroids with fluid-air levels, consistent with pyomyoma. Despite initial broad-spectrum antibiotics and supportive care, the patient required surgical removal of the prolapsed necrotic fibroid. Postoperatively, the patient stabilized with targeted antibiotic therapy and supportive management, achieving full recovery. This case underscores the importance of early recognition and intervention in UAE-related complications to prevent severe outcomes and showed the potential for uterus-preserving management strategies. Keywords: Pyomyoma, uterine artery embolization, uterine leiomyoma, sepsis, necrotic fibroid, fertility-preserving surgery.