Uterine AVMs May Present With Abnormal Vaginal Bleeding

Background
Abnormal menstrual bleeding in the premenopausal period is usually attributed to uterine fibroids. Other entities such as adenomyosis, uterine arteriovenous malformation (AVM), arteriovenous fistula, and polyps should also be considered.

Uterine AVM can be a source of heavy vaginal bleeding and can be treated successfully with transcatheter embolization.

This article will present a case report describing the successful endovascular treatment of AVM.

Case Report
The authors describe a case report of a patient with heavy vaginal bleeding who had failed medical therapy to control the bleeding. The diagnostic workup included a pelvic ultrasound and MRI, which showed an abnormal tangle of vessels at the uterine fundus.

An angiogram and subsequent transcatheter embolization of a uterine AVM were then performed, and the symptoms resolved.

Conclusions
Uterine AVM should be considered in a young patient with severe vaginal bleeding and a negative result for serum beta-HCG.

Author: Sohail Contractor, MD

Reference:
Rangarajan RD, Moloney JC, Anderson HJ. Diagnosis and Nonsurgical Management of Uterine Arteriovenous Malformation. Cardiovasc Intervent Radiol; 2007; 30 (November-December): 1267-1270