Obstet Gynecol Sci.  2013 Sep;56(5):333-337.

Failed transarterial embolization of subserosal uterine arteriovenous malformation

Affiliations
  • 1Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Korea. hwanghs@kuh.ac.kr
  • 2Department of Radiology and Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.

Abstract

Uterine arteriovenous malformation (AVM) is rare but potentially life-threatening from excessive vaginal bleeding. All uterine AVMs reported to date have been found in the endometrial or myometrial layers. Here we present a patient with a subserosal type AVM on the fundus of uterus, which spontaneously ruptured.

Keyword

Arteriovenous malformation; Spontaneous rupture; Therapeutic embolization

MeSH Terms

Arteriovenous Malformations
Embolization, Therapeutic
Humans
Rupture, Spontaneous
Uterine Hemorrhage
Uterus

Figure

  • Fig. 1 Sagittal transvaginal gray-scale and color Doppler ultrasonographic images and pelvic angiography. (A) Multiple serpentine anechoic myometrial structures are showed by gray-scale image. (B) Multidirectional high-velocity vascular flow is demonstrated by color Doppler ultrasonographic scan. (C, D) About 1.7×1.7 cm sized anechoic round lesion with high velocity vascular flow (arrowhead) is noted on fundal area of uterus. (E) Abdominal aortogram shows enlarged bilateral uterine arteries and fundal arteriovenous malformation (AVM) (arrow). (F) Left ovarian angiography demonstrates additional supply to the AVM by enlarged, tortuous ovarian artery. (G) Postembolization aortogram for bilateral uterine arteries and left ovarian artery reveal no residual AVM flow.

  • Fig. 2 Magnetic resonance image of ruptured arteriovenous malformation (AVM), and macroscopic findings by emergency exploratory laparotomy. (A) Axial and (B) sagittal computed tomography scan images demonstrate rupture of cystic lesion on left fundal portion of uterus (arrowhead). Large amount hemoperitoneum is noted in abdominopelvic cavity. (C) About 3×3 cm sized subserosal type AVM is noted on fundus (arrow). (D) The ruptured AVM is removed, and repaired.


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