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

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.

Use of urinary balloon catheter to prevent postoperative bleeding after ultrasound‐guided vacuum‐assisted breast biopsy

“…Postoperative bleeding is the most common serious complications. It was reported that some cases of bleeding could not be controlled by the standard postprocedural compression following VABB and even required surgical intervention for hemostasis . Apparently, this complication will have a negative effect on patient's recovery.…”

“…14 VABB and even required surgical intervention for hemostasis. 16,17 Apparently, this complication will have a negative effect on patient's recovery. How to prevent postoperative bleeding is still a challenge for the application of VABB.…”

A novel treatment for breast pseudoaneurysm in the anticoagulated patient

“…Treatment can range from manual pressure to surgical ligation. Factors involved in determining the need for definitive intervention include the size of the PA, rate of growth, and need for anticoagulation 1‐7 . Our case describes the first reported successful treatment of a breast PA in an anticoagulated patient.…”

Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy

“…Needle biopsies can cause several complications including breast bruising, bleeding and hematoma formation [Chou et al 2012]. Controlling an active hemorrhage is a major challenge as a complication of biopsy procedures and therefore clinicians try to take necessary precautions to prevent this complication [Sun et al 2014].…”

“…SAds consist of selective serotonergic reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and some tricyclic antidepressants (TCAs) with high affinity to serotonin receptors [Mahdanian et al biopsies can cause several complications including breast bruising, bleeding and hematoma formation [Chou et al 2012]. Controlling an active hemorrhage is a major challenge as a complication of biopsy procedures and therefore clinicians try to take necessary precautions to prevent this complication [Sun et al 2014].…”