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Can Tho: Saving the life of a patient with critical pulmonary embolism and hemorrhage

Can Tho Central General Hospital has just successfully treated a patient with severe uterine bleeding due to endometriosis and pulmonary embolism who was admitted to the hospital on June 11.

VietnamPlusVietnamPlus16/06/2025

Can Tho Central General Hospital has just coordinated with many specialties, especially doctors from the endovascular intervention department, to successfully treat a patient with severe uterine bleeding due to endometriosis and pulmonary embolism.

Previously, at 5:27 p.m. on June 11, 2025, Can Tho Central General Hospital received a female patient named PDH (49 years old), from Vinh Long province in critical condition: fatigue, difficulty breathing, severe edema and pain in the right leg and heavy vaginal bleeding.

The patient had a history of endometriosis causing dysmenorrhea and prolonged menorrhagia and was treated medically with oral contraceptives for several months. She then had an implant for treatment, but the pain and menorrhagia and menorrhagia did not improve. At the same time, the patient was also being treated for hypertension and hypothyroidism.

Four days before being admitted to Can Tho Central General Hospital, the patient had severe vaginal bleeding and received initial emergency treatment at a local medical facility.

At Can Tho Central General Hospital, test results showed that the patient had severe anemia. Ultrasound of the blood vessels in both lower limbs showed blood clots.

Chest CT scan with contrast showed partial thrombosis of the main pulmonary artery branches on both sides. Diagnosis was endometriosis with complications of menorrhagia causing severe anemia, venous thrombosis of the limbs - pulmonary embolism. The patient is at high risk of death if not treated promptly.

The patient was quickly resuscitated and transfused. In principle, pulmonary embolism treatment requires the use of anticoagulants, however, patients with bleeding are contraindicated for anticoagulants. Immediately, a multidisciplinary consultation including Obstetrics, Cardiology, Diagnostic Imaging, etc. agreed to perform emergency endovascular intervention to control severe vaginal bleeding due to endometriosis. This is the optimal treatment option for the patient with minimally invasive methods and optimal treatment.

The images showed that the uterus was mainly supplied with blood from the right internal iliac artery with many branches of increased vascularity. The intervention team performed uterine embolization using biological glue. Once the bleeding location was determined, the team successfully embolized the vessel after only 45 minutes. Once the bleeding was controlled, the patient was immediately given anticoagulants to treat pulmonary embolism.

Currently, the patient is no longer bleeding, vital signs are stable, and anticoagulant treatment is continuing according to the pulmonary embolism protocol. According to Specialist II Doctor Nguyen Huu Thoi - Head of Obstetrics Department, Can Tho Central General Hospital, endometriosis is a common obstetric and gynecological disease, mostly occurring in the age group of 30-50 years old.

Common symptoms include abdominal pain, menorrhagia, irregular menstrual cycles, and uterine enlargement. Endometriosis usually resolves spontaneously after menopause. Some patients may only need medication to relieve symptoms and follow-up, especially those approaching menopause.

In some cases, severe or long-term menorrhagia can lead to severe, life-threatening anemia. These patients require special care and intervention.

One of the most advanced intervention methods today for cases of endometriosis with complications of bleeding/menorrhagia is endovascular intervention./.

(Vietnam+)

Source: https://www.vietnamplus.vn/can-tho-cuu-song-benh-nhan-xuat-huyet-kem-thuyen-tac-phoi-nguy-kich-post1044598.vnp


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