Embolization of uterine arteriovenous malformation for treatment of menorrhagia |
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Authors: | Patel Sapna Potti Sushma Jaspan David Dandolu Vani |
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Institution: | (1) Department of Obstetrics/Gynecology, Temple University School of Medicine, Philadelphia, PA 19140, USA;(2) Department of Obstetrics/Gynecology, Albert Einstein Medical Center, Philadelphia, PA 19140, USA |
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Abstract: | Background Uterine arteriovenous malformations are rare but potentially life-threatening conditions that should be suspected in unexplained
severe vaginal bleeding.
Case A 28-year-old gravida 7, para 3 presented to the emergency department with heavy vaginal bleeding and passage of blood clots.
In the emergency room, her hemoglobin dropped from 11.2 to 7.4 gm%. Transvaginal ultrasonographic scan showed a large vascular
mass in the uterus measuring 2.6 cm in diameter with low resistance of flow within, concerning for arteriovenous malformation
or an arteriovenous fistula. Digital subtraction arteriography confirmed the lesion. She underwent angiography and bilateral
uterine artery embolization.
Conclusion The diagnosis of uterine arteriovenous malformation requires a high index of suspicion in the scenario of unexplained severe
vaginal bleeding. Digital subtraction angiography is the gold standard for definitive diagnosis and allows immediate treatment
by embolization. |
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Keywords: | Uterine aretriovenous malformation Arteriovenous malformation Therapeutic embolization |
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