Rare case: Massive bleeding due to uterine arteriovenous fistula

After being examined for persistent vaginal bleeding, a woman was diagnosed with a rare condition: uterine arteriovenous fistula.

On August 27, information from Da Nang Family Hospital said that the hospital had just successfully treated a female patient, KV (35 years old), who suffered from a rare disease: uterine arteriovenous fistula. This is a type of blood vessel abnormality that can threaten fertility and life if not treated promptly.

Previously, Ms. V. was admitted to the emergency room with massive vaginal bleeding, bright red blood with small blood clots after a 1-month miscarriage (20-week-old fetus). Although she did not have a fever or severe abdominal pain, Ms. V. was constantly exhausted, dizzy and lightheaded.

After examination, doctors discovered a complex tubular structure in the uterine muscle with turbulent flow, high velocity..., signs of suspected uterine arteriovenous fistula.

To determine the exact cause, the patient was ordered to have an abdominal CT scan with contrast. The results showed an arteriovenous fistula located in the uterine body, measuring about 4.5x4.7 cm.

MSc. Nguyen Thi Huyen My examined Ms. V. before discharge from the hospital.

PHOTO: SX

After a multidisciplinary consultation, the doctors agreed to choose selective uterine artery occlusion under digital subtraction angiography (DSA) to treat Ms. V. Within more than 1 hour, with the support of the DSA system, the doctors quickly determined the location of the arteriovenous fistula.

The abnormal vein is located in the uterine body area, supplied with blood by many branches of the left uterine artery. The vein is dilated, twisted, and difficult to observe.

The intervention team successfully approached, accurately selected the feeding vessels and injected embolic agents to completely block the abnormal communication area. The results of the subsequent scan confirmed that the arteriovenous fistula had been completely treated.

After the intervention, Ms. V's health stabilized, her abnormal vaginal bleeding gradually decreased, her uterus was preserved intact and she was discharged from the hospital.

According to MSc. Dr. Nguyen Thi Huyen My (Vascular Interventional Stroke Unit), selective arterial occlusion guided by the DSA system has become the preferred choice thanks to its safety, effectiveness and minimal invasiveness.

This method not only controls acute bleeding well but also helps preserve the uterus and ovaries, which is especially important for young women who still want to have children in the future.

MSc. Nguyen Thi Thanh Loan, Head of the Department of Obstetrics and Gynecology at Family Hospital, added: uterine arteriovenous fistula is an abnormal connection between the blood vessels of the uterus; the most common symptom is abnormal vaginal bleeding.

Although rare, uterine arteriovenous fistulas can cause massive bleeding, especially in women of reproductive age. If not detected and treated properly, the patient may face the risk of having to remove the uterus to control the bleeding, affecting the ability to conceive, physical health and psychological health.

Source: https://thanhnien.vn/ca-hiem-xuat-huyet-o-at-vi-thong-dong-tinh-mach-tu-cung-185250827095459636.htm