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  • Title: Resection of uterine arteriovenous fistula with temporary occlusion of the internal iliac arteries: Case series and literature review.
    Author: Chen J, Huang D, Yang J, Zhang S.
    Journal: Medicine (Baltimore); 2024 Aug 30; 103(35):e39442. PubMed ID: 39213197.
    Abstract:
    RATIONALE: Uterine arteriovenous fistula (UAVF) is a rare vascular abnormality that can cause severe and potentially life-threatening hemorrhage. Uterine artery embolization is a common treatment that may affect ovarian and uterine perfusion and cause fertility problems. We herein report our experience treating 2 patients with UAVF who underwent resection after temporary occlusion of both internal iliac arteries. PATIENT CONCERNS: Both patients presented with a large UAVF after incomplete miscarriages in the second trimester. Magnetic resonance imaging revealed a UAVF measuring 3.6 × 2.6 × 2.1 cm over the myometrium of the posterior uterine in case 1, and a UAVF of 7.1 × 4.1 × 4.5 cm was identified in case 2. DIAGNOSIS: Uterine arteriovenous fistula, retained products of conception. INTERVENTIONS: The patients underwent resection of UAVF with temporary occlusion of the internal iliac arteries and hysteroscopic removal of the retained products of conception. OUTCOMES: Intraoperative bleeding were minimal. Neither patient exhibited abnormal uterine bleeding at the 6-month follow-up. Follow-up ultrasonography and magnetic resonance imaging showed normal uterine myometrium and endometrium and no residual disease. LESSONS: UAVF resection after temporary occlusion of the internal iliac arteries is a promising treatment approach for UAVF. This technique can reduce intraoperative bleeding and remove the potential hemorrhage-related lesion while preserving fertility.
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