Bilateral iliac embolization for delayed postoperative vaginal cuff bleeding complicated by non-target embolization of the labia

This case describes a 41 year-old female who underwent a robotic-assisted total laparoscopic hysterectomy in the setting of adenomyosis which was complicated by postoperative vaginal bleeding requiring additional surgical management. She continued to have vaginal bleeding following re-operation and the decision was made to proceed with iliac artery embolization with Interventional Radiology. Following the embolization, the patient’s bleeding was well controlled. While it is well known that uterine artery embolization is an option for management of bleeding for patients with fibroids, there are no current cases reported in the literature of embolization following hysterectomy. This is a unique case with potential clinical impact for future management of postoperative bleeding complications.