Gabasa-Gorgas L, Pérez-Muñoz A, Procas-Ramón B, Polo-Oliveros L, Jiménez-Martínez D, Sobreviela-Laserrada M

Language: Spanish
References: 0
Page: 392-396
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ABSTRACT

Background: Uterine arterio-venous fistula is one of the most frequent vascular malformations. A heavy vaginal bleeding should make us suspect the presence of this type of vascular malformation.
Clinical case:A 51-years-old patient was admitted in Emergency Service for heavy vaginal bleeding of one month of evolution. On physical examination, external genitalia and vagina were normal but uterus had slightly increased in size. A transvaginal ultrasound with color Doppler was performed where an increase in uterine vascularization was shown. Subsequently, an office hysteroscopy was carried out confirming the diagnosis of uterine arterio-venous fistula. After a correct anesthetic evaluation, a surgical hysteroscopy was performed, using speculum, Pozzi clamp, dilation with Hegar stems up to number 9.5, coagulation resectoscope Storz Gyrus with Collins loop handle with bipolar energy at 45 watt of coagulation and physiological saline, as a means of relaxation. The arterio-venous malformation was coagulated at several levels until the obliteration of the fistula was completed. The postoperative period was favorable. In the subsequent follow-up in consultation, the patient continues asymptomatic.
Conclusions: Hysteroscopy is an effective, minimally invasive method with low morbidity to establish the diagnosis and treatment of vascular malformations.