EP26.20: Uterine arteriovenous fistula: case report

Uterine arteriovenous fistula are very rare but they can represent a life-threatening reason of vaginal bleeding. Generally, patient affected is a multiparous woman. The origin can be congenital or acquired, being more frequent after uterine surgery and presenting mainly as arteriovenous fistulous connections into the myometrium supplied by uterine arteries. Case report: We report the case of a 33-year-old patient who presented in our department for important vaginal bleeding. The ultrasound transvaginal colour-Doppler examination revealed intrauterine tubular and tortuous structures with mixed signal from arterial and venous flows located mostly at the uterine istmus with involvement of the uterine anterior wall at the Caesarean scar situs. The immediate diagnosis was of acquired uterine arteriovenous malformation. The obstetrical medical history of the patient revealed two Caesarean section in the last 4 years and a termination of pregnancy by curettage in the last 6 months. The treatment was endovascular embolisation, which was performed rapidly in other medical unit, due to reduced possibilities of our hospital. The postprocedural evolution of the patient was favourable. In conclusion, the congenital or acquired uterine arteriovenous malformation may be a diagnosis in any patient with vaginal bleeding. The diagnosis is made exclusively by Doppler ultrasound examination and the treatment is multidisciplinary. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.