Pyomyoma after Uterine Artery Embolization for Postpartum Hemorrhage Misdiagnosed as Uterine Necrosis

A 34-year-old female patient underwent uterine artery embolization (UAE) to control massive postpartum hemorrhage. The interventional radiologist was not informed of the patient’s significant history of uterine myoma. Although no significant signs of complications or “red flags” were observed during the procedure, follow-up computed tomography performed four weeks later revealed evidence of a large, globe-like fluid collection with air bubbles in the uterus. The finding and pathology was initially diagnosed as uterine necrosis, which led not to interventional percutaneous drainage; instead, dilation and curettage with resectoscope was performed. The surgical and pathological diagnosis was “expulsion of pyomyoma in the uterine cavity.” Awareness and precise knowledge of imaging findings of pyomyoma and uterine necrosis are important for early diagnosis and treatment of UAE-related complications.