Compression-refractory breast hematoma secondary to pseudoaneurysm after stereotactically guided vacuum-assisted biopsy: the critical role of urgent surgical evacuation

J Clin Ultrasound. 2014 Oct;42(8):492-4. doi: 10.1002/jcu.22202. Epub 2014 Jul 3.

Abstract

We report the case of a patient who underwent a vacuum-assisted biopsy of amorphous clustered microcalcifications complicated by a large compression-refractory hematoma secondary to pseudoaneurysm formation. Breast sonography was used to identify an actively bleeding vessel and guide compression. However, due to its unresponsiveness to conventional management and rapid progression, the hematoma required surgical evacuation and ligation of the bleeding vessel. This suggests that, in the face of significant intractable bleeding, a heightened awareness of the possible need for surgical intervention should be maintained.

Keywords: breast ultrasonography; drainage; hematoma; pseudoaneurysm; vacuum-assisted biopsy.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / complications
  • Aneurysm, False / diagnosis*
  • Breast Diseases / diagnosis*
  • Breast Diseases / etiology
  • Breast Diseases / surgery
  • Drainage / methods*
  • Emergencies
  • Female
  • Hematoma / diagnosis*
  • Hematoma / etiology
  • Hematoma / surgery
  • Humans
  • Image-Guided Biopsy / methods*
  • Imaging, Three-Dimensional / methods
  • Mammary Arteries*
  • Middle Aged
  • Ultrasonography, Doppler, Color / methods*
  • Vacuum