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Erschienen in:
14.08.2018 | Pictorial Essay
Uterine Balloon Tamponade: A Savior in Ruptured Uterine Arteriovenous Malformation
Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 6/2018
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30 years second para had menorrhagia for 2 months after D & E. USG and pelvic angiogram were suggestive of uterine AVM on left side (Figs. 1, 2, 3). Patient gave negative consent for uterine artery embolisation. She started bleeding torrentially leading to hypotension. Hence balloon tamponade was done that kept the bleeding under control for 12 days till hysterectomy was done after the couple insisted for hysterectomy. Gross specimen and HPR proved the diagnosis (Figs. 4, 5).
Fig. 1
CT Pelvic Angiogram: showing multiple, tiny linear serpigeneous flow void structures in myometrium predominantly in left posterolateral aspect with mild sub-mucous projections suggesting AV malformation of uterine myometrium with feeding vessels arising from bilateral internal iliac arteries
Fig. 2
USG Doppler: normal sized uterus with endometrial thickness of 8 mm; significantly raised vascularity seen in myometrial - endometrial junction and focally in endometrium. Findings were suggestive of arterio-venous malformation (AVM) of uterus in lower segment
Fig. 3
USG-Gray scale: showing multiple tubular or ‘spongy’ anechoic or hyperechoic areas within the myometrium
Fig. 4
Gross specimen of the uterus
Fig. 5
Histopathology: showing dilated & ecstatic vessels with anastomosing arteries & veins; dilated, ecstatic & thrombosed vessels throughout the myometrium. No evidence of any malignancy in the sections studied
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