{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:24:32Z","timestamp":1783398272607,"version":"3.54.6"},"reference-count":9,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,3]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Pyomyoma, a rare complication of uterine artery embolisation (UAE) for symptomatic fibroids, can closely mimic post-embolisation syndrome (PES), which typically presents with pain, fever and leucocytosis within the first week. Differentiating PES from pyomyoma is critical, as pyomyoma carries a higher risk of severe complications. We report a case of an unmarried nulliparous woman who developed pyomyoma following UAE for fibroids. Initially suspected to have PES, her persistent high-grade fever, purulent discharge and imaging findings of gas pockets within a necrotic fibroid led to the diagnosis of pyomyoma. Despite initial treatment with broad-spectrum antibiotics, emergency laparotomy was required, revealing a necrotic, pus-filled fibroid. The infected tissue was excised, and careful surgical reconstruction of the uterus was performed, successfully preserving her fertility. This case underscores the importance of timely intervention and uterine-preserving approaches in patients with prolonged or worsening symptoms after UAE to optimise both clinical and reproductive outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2024-264207","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T11:56:27Z","timestamp":1738065387000},"page":"e264207","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Uterine preservation in pyomyoma complicating uterine artery embolisation"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-867X","authenticated-orcid":false,"given":"Satish","family":"Choudhury","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avantika","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayushi","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiology, All India Institute of Medical Science Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"2025082803094988000_18.1.e264207.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2011.12.002"},{"key":"2025082803094988000_18.1.e264207.2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.radcr.2019.05.009","article-title":"Uterine-sparing management of pyomyoma after uterine fibroid embolization","volume":"14","author":"Yu","year":"2019","journal-title":"Radiol Case Rep"},{"key":"2025082803094988000_18.1.e264207.3","doi-asserted-by":"crossref","unstructured":"Rezai S . Pyomyoma Following Uterine Artery Embolization (UAE) \u2013 Dual Case Report and Review of Literature. OGIJ 2016;4. doi:10.15406\/ogij.2016.04.00097","DOI":"10.15406\/ogij.2016.04.00097"},{"key":"2025082803094988000_18.1.e264207.4","doi-asserted-by":"crossref","DOI":"10.25259\/JCIS_188_2021","article-title":"Ruptured pyomyoma - Rare complication of post-uterine artery embolization: A case report","volume":"11","author":"Vulasala","year":"2021","journal-title":"J Clin Imaging Sci"},{"key":"2025082803094988000_18.1.e264207.5","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/S1028-4559(10)60072-1","article-title":"Pyomyoma: a rare and life-threatening complication of uterine leiomyoma","volume":"49","author":"Chen","year":"2010","journal-title":"Taiwan J Obstet Gynecol"},{"key":"2025082803094988000_18.1.e264207.6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.jvir.2007.11.021","article-title":"Postembolization syndrome: changes in white blood cell counts immediately after uterine artery embolization","volume":"19","author":"Ganguli","year":"2008","journal-title":"J Vasc Interv Radiol"},{"key":"2025082803094988000_18.1.e264207.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-008-9483-6"},{"key":"2025082803094988000_18.1.e264207.8","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.jmig.2012.07.001","article-title":"Conservative laparoscopic approach to a perforated pyomyoma after uterine artery embolization","volume":"19","author":"Pinto","year":"2012","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082803094988000_18.1.e264207.9","doi-asserted-by":"crossref","first-page":"129S","DOI":"10.1097\/01.AOG\/01.AOG.0000559239.34428.1b","article-title":"Management of Pyomyoma After Embolization of Large, Submucosal Fibroid With Emergent Vaginal Myomectomy [5L]","volume":"133","author":"McKendrick","year":"2019","journal-title":"Obstetrics & Gynecology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264207","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:01Z","timestamp":1756375801000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,28]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-264207"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264207","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}