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Uterine arteriovenous fistula

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

2 months post-partum with ongoing per vaginal bleeding. bHCG negative.

Patient Data

Age: 25 years
Gender: Female
ultrasound
  • Retroverted uterus
  • Mass like conglomerate of tubular anechoic spaces in the anterior wall of the uterus (retroverted)
  • High flow low resistance pattern on doppler
  • Trace of anechoic intrauterine fluid with thin endometrium
  • Normal ovaries with follicles

Ultrasound findings are consistent with (acquired) uterine arteriovenous fistula.

Case Discussion

Uterine arteriovenous fistula (malformation) describes an abnormal area of communication between arteries and veins of the uterus without an intervening capillary network. They can be congenital (malformation), which is rare, or acquired (fistula).

Causes of acquired uterine arteriovenous fistula include:

  • vaginal delivery
  • miscarriage
  • instrumentation (such as dilation and curettage, surgical termination, and cesarean section)

 

Case with thanks to Dr George Harisis.

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