Emphysematous endometritis following postpartum uterine artery embolization: A case report

Emphysematous endometritis is a rarely described clinical entity. The present report describes the case of a 44 -year-old woman who presented 2 weeks postpartum with abdominal pain, malodorous vaginal discharge, fever, and paresthesia in the setting of uterine embolization. Imaging showed emphysematous changes in the wall of the uterus. Histology of the hysterectomy sample showed acute suppurative myometritis, subserosal neutrophilic infiltrates, and emphysematous air pockets; these were accompanied by embolic material, bacterial clumps, and granulation tissue. Her recovery from the hysterectomy was without further complications. • Emphysematous endometritis is an extremely rare postpartum entity. • In the reported case it occurred after uterine artery embolization for postpartum hemorrhage. • Computerized tomography demonstrated gas within the uterine wall and cavity. • Histology revealed transmural coagulative necrosis and suppurative myometritis and gas pockets. • Hysterectomy and broad-spectrum antibiotics led to recovery.