CardioVascular and Interventional Radiology

, Volume 36, Issue 4, pp 1173–1173 | Cite as

Reply to Letter re: Non-target Embolization or Local Effect of Infarction?

Letter to the Editor


Nuclear Medicine Local Effect Large Bowel Transverse Colon Uterine Artery Embolization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Dear Sir,

We thank the authors for their interest in our case report. The cause of perforation of transverse colon 3 months after uterine artery embolization cannot be established for certain, but the fact that the perforated colon is stuck down to the large necrotic fundal fibroid suggest that direct, local inflammatory involvement is likely. Small- or large-bowel injury from uterine artery embolization is surprisingly rare even for large fibroid uterus but a few cases have been reported previously [1, 2]. We maintain that the risk of such complication is higher if a large serosal fibroid on the fundus of uterus is present, as in this case. If there is colonic infarction at the time of uterine artery embolization, it is not clear why the patient would have bowel perforation 3 months later, when there is a relative absence of symptoms of ischaemic bowel injury in the interim.

Finally, we are not advocating early laparotomy for all cases but where there is sufficient clinical concern and risk factors for bowel injury are present, even if imaging is normal, the risks of laparotomy may be outweighed by the benefits. As in the present case, where irrespective of the mechanism of large bowel injury, there seems to be no other way of treating such a catastrophic complication.


Conflict of interest



  1. 1.
    Goldberg J, Boyle K, Choi M et al (2005) Small bowel obstruction due to adhesive disease observed. Am J Obstet Gynaecol 193:892–893CrossRefGoogle Scholar
  2. 2.
    Virmani V, Fasih N, Rakhra K (2011) Intraluminal bowel obstruction by a detached fibroid—an extremely unusual complication of uterine artery embolization. Clin Radiol 66:795–797PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2013

Authors and Affiliations

  1. 1.Stepping Hill HospitalStockportUK
  2. 2.8 Watermint Way, West TimperleyCheshireUK
  3. 3.Royal Bolton HospitalBoltonUK

Personalised recommendations