J Korean Soc Emerg Med.  2018 Feb;29(1):93-99. 10.0000/jksem.2018.29.1.93.

Life-threatening Hemorrhage Caused by Mandibular Arteriovenous Malformation: A Case Report

Affiliations
  • 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. kwkim@yuhs.ac
  • 2Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.
  • 3Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.
  • 5Department of Medicine, Sowha Children's Hospital, Seoul, Korea.

Abstract

Arteriovenous malformation (AVM) of the mandible is a rare vascular condition that can manifest as a wide range of symptoms and, on rare occasions, cause fatal hemorrhage. The symptoms of mandibular AVM can range from soft tissue swelling and tooth mobility to severe hemorrhage. The recognition of early symptoms is crucial for the prevention of a fatal hemorrhage and for the proper diagnosis and treatment of mandibular AVM. For emergency hemostasis of a ruptured mandibular AVM, manual compression with gauze, topical thrombin, absorbable hemostat, suturing the lesion, and replanting the extracted tooth is recommended. Multiple treatment options for mandibular AVM are available, such as arterial embolization, venous embolization, direct surgical closure, and bone resection. A combination of treatment options should be considered in complicated cases. We report a case of a 10-year-old girl with a previous history of telangiectasia on the right cheek presented with cardiac arrest resulting from massive bleeding immediately after a tooth extraction.

Keyword

Arteriovenous Malformations; Mandible; Hemorrhage; Therapeutics

MeSH Terms

Arteriovenous Malformations*
Cheek
Child
Diagnosis
Emergencies
Female
Heart Arrest
Hemorrhage*
Hemostasis
Humans
Mandible
Telangiectasis
Thrombin
Tooth
Tooth Extraction
Tooth Mobility
Thrombin
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