Arteriovenous malformations
A 26 year old known case of idiopathic thrombocytopenic purpura on
dapsone therapy with a recent history of medical termination of
pregnancy followed by Mirena insertion presented with menorrhagia.
Ultrasound study showed no evidence of intrauterine Mirena device and
was suggestive of a possible arteriovenous (AV) fistula formation, which
was likely acquired. CECT abdomen for further evaluation confirmed an
arterial enhancing lesion (1.7 x 1.5 cm) in the myometrium of the
anterior uterine body with multiple tiny vascular channels and draining
vein suggestive of uterine AV malformation -with a feeder from right
uterine artery, however the right uterine artery was not hypertrophied.
No abnormal vascular channel was seen from left uterine artery and
adnexa was normal. Right uterine artery embolisation was done and
findings of tortuous right uterine artery with, prominent and abnormal
leash of blood vessels noted. (Figure2). Following embolisation the
symptoms resolved.