Embolization of Inferior Mesenteric Artery for Intractable Intrapelvic and Vaginal Bleeding After Hysterectomy

Branches of the internal iliac artery or ovarian artery are the typical sources of pelvic hemorrhage. The inferior mesenteric artery has been rarely reported as the origin of pelvic bleeding. We present 2 cases of intractable intrapelvic and vaginal bleeding after hysterectomy. One patient underwent a hysterectomy because of uncontrolled postpartum hemorrhage and another underwent a vaginal hysterectomy to treat vaginal prolapse. Both patients were subjected to angiography to control continuous vaginal bleeding after hysterectomy. The angiography revealed that the bleeding originated from the inferior mesenteric artery. Selective embolization of the inferior mesenteric artery successfully controlled the intractable intrapelvic and vaginal bleeding without complications. The inferior mesenteric artery is a potential source of intractable intrapelvic and vaginal bleeding for patients with a lower genital tract injury.