Obstet Gynecol Sci.  2014 Sep;57(5):419-423. 10.5468/ogs.2014.57.5.419.

Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy

• Chang KH
• Park JK
• Park SH
• Kim HB
• Park ST

• KMID: 2051728
• DOI: http://doi.org/10.5468/ogs.2014.57.5.419

Abstract

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology with fewer than 100 cases reported in the literature. Due to abnormal connection between arteries and veins without an intervening capillary system, recurrent and profuse vaginal bleeding is the most common symptom which can be potentially life-threatening. Uterine AVM can be either congenital or acquired. Acquired AVM is reported as a consequence of previous uterine trauma such as curettage procedures, caesarean section or pelvic surgery. It is also associated with infection, retained product of conception, gestational trophoblastic disease, malignancy and exposure to diethlystilboestrol. We herein report a case of acquired uterine AVM located on the right lateral wall after intrauterine instrumentation for laparoscopic left salpingectomy due to left tubal pregnancy. The patient was successfully treated with embolization.

Keyword

Intrauterine instrumentation; Tubal pregnancy; Uterine arteriovenous malformation

MeSH Terms

Arteries
Arteriovenous Malformations*
Capillaries
Cesarean Section
Curettage
Female
Fertilization
Gestational Trophoblastic Disease
Gynecology
Humans
Laparoscopy*
Pregnancy
Pregnancy, Tubal*
Salpingectomy
Uterine Hemorrhage
Veins

Figure

• 

  Fig. 1 The initial transvaginal ultrasonography showed no abnormal findings within the myometrium of the uterus (A). Transvaginal ultrasonography showed tubular lesion surrounded by anechogenic cystic space in the right lateral wall of myometrium with pulse rate of 71 beats/min (B) and computerized tomography scan showing contrast-opacified structure surrounded by low density lesion (C), suggesting arteriovenous malformation.

• 

  Fig. 2 The uterine artery angiogram confirmed the presence of an arteriovenous malformation in the right lateral wall region, originating from right uterine artery (A), which was successfully treated by embolization (B).

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