Post-uterine fibroid embolization sepsis: A case report and review of the literature

Background: Sepsis is a rare complication from uterine fibroid embolization (UFE) and often arises from a devascularized fibroid that must be treated with hysterectomy. Case: A 49-year-old multigravida presented with sepsis as a complication of recent UFE. She underwent total laparoscopic hysterectomy (TLH) and bilateral salpingectomy. Results: A literature review revealed 27 additional cases of sepsis after UFE. The mean age of the patients was 43.6 and the mean time to presentation after UFE was 25.0 days. Of these patients, 21 required hysterectomy and 2 died - a mortality rate of 7.4%. The current patient presented with septic shock and did not have resolution of her symptoms until she underwent a TLH and bilateral salpingectomy. Conclusions: Sepsis following UFE is associated with a high rate of mortality, and, while not previously described in the literature, it was still possible to conclude that laparoscopy could be a reasonable option to provide source control for a proper candidate with post-UFE sepsis.