Retroperitoneal hematoma secondary to rupture of uterine artery pseudoaneurysm after cesarean section, managed by selective embolization: A case report

A 35-year-old woman underwent a cesarean section at our hospital. Five days postoperatively, she presented with abdominal pain, vomiting, and deterioration of her general condition. Laboratory tests revealed hypotension with a blood pressure of 90/70 mmHg and a hemoglobin level of 6 g/dL, without any signs of external bleeding. After initial stabilization, an ultrasound examination with Doppler followed by a CT scan was performed, demonstrating a retroperitoneal hematoma and a saccular vascular lesion of the uterine artery consistent with a pseudoaneurysm. The patient was successfully treated by selective arterial embolization, resulting in excellent clinical outcomes. This case illustrates the importance of Doppler ultrasound in establishing a prompt diagnosis, particularly for nonexperienced radiologists, and highlights selective embolization as an effective and minimally invasive treatment option for postpartum hemorrhage caused by uterine artery pseudoaneurysm in hemodynamically stable patients. It underscores the value of early imaging in the detection of postoperative complications and supports consideration of nonsurgical interventions prior to surgical management when appropriate.