Uterine arteriovenous malformation inadvertently treated by
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"Uterine arteriovenous malformations (AVMs) are one of the causes of potential severe genital hemorrhages. Acquired AVMs are considered iatrogenic and mainly diagnosed after pregnancy termination and/or uterine surgery. The diagnosis is based on ultrasound, computed tomography, magnetic resonance imaging and angiography. Uterine artery embolization and hysterectomy represent the current treatments of choice. Uterine curettage is not recommended for AVMs treatment due to high risk of hemorrhage. We report on a patient with an AVM occasionally diagnosed and managed by hysteroscopy, a treatment never reported in literature.
Case Report: A 52-year-old patient complaining of abnormal uterine bleeding, submitted to a cesarean section 29 years before, was scheduled to hysteroscopy resection of an intrauterine lesion suggestive of submucosal myoma at saline infusion ultrasonography. Rather than a myoma, hysteroscopy imaging was consistent with an endometrial polyp with no abnormal vascularization. The slicing of the mass was hampered by bleeding from a crowding of arterial and venous vessels; near the pedicle, a worsening of bleeding precluded an adequate visualization causing the premature interruption of the surgery. Bleeding control was obtained by the placement of a balloon. The pathologic examination confirmed an AVM. One month later, ultrasound, computed tomography and hysteroscopy showed no residual mass."....