PDF(Pubmed)
Abstract：
BACKGROUND: Arteriovenous malformation (AVM) leads to a direct connection between arterial and venous networks, in which capillary branches are not involved. Pelvic AVM is a benign and rare condition causing severe pain, hematuria, and rectal or vaginal bleeding.
METHODS: A 36-year-old woman presented with five months history of hematuria. Her medical history was unremarkable, and laboratory findings were all within normal ranges. Abdominopelvic computed tomography (CT) scan revealed a vascular mass in the left lateral pelvis that extended to the bladder neck and was suggestive of an AVM. The patient underwent a laparotomy for the resection of AVM. The first angiography revealed an AVM in the left internal iliac artery. The patient underwent embolization with coil and gel foam. The second angiography revealed complete obstruction of the left internal iliac artery due to multiple coils and AVM of the right internal iliac artery (RIIA), embolized with glue and lipiodol. A week later, venography revealed another left iliac vein malformation embolized with foam sclerotherapy. Forty days later, the third angiography revealed another AVM in the right iliac artery, embolized with three vials of polyvinyl alcohol (PVA). Following two months of follow-up, the symptoms did not return.
CONCLUSIONS: The present study reported a rare case of recurrent pelvic AVM causing painless hematuria in a female patient. The lesion was treated with several angioembolization sessions.
CONCLUSIONS: Angioembolization is one of the main therapeutic options for AVM. Appropriate material should be precisely chosen for AVM embolization regarding the AVM\'s location, size, and condition.
METHODS: A 36-year-old woman presented with five months history of hematuria. Her medical history was unremarkable, and laboratory findings were all within normal ranges. Abdominopelvic computed tomography (CT) scan revealed a vascular mass in the left lateral pelvis that extended to the bladder neck and was suggestive of an AVM. The patient underwent a laparotomy for the resection of AVM. The first angiography revealed an AVM in the left internal iliac artery. The patient underwent embolization with coil and gel foam. The second angiography revealed complete obstruction of the left internal iliac artery due to multiple coils and AVM of the right internal iliac artery (RIIA), embolized with glue and lipiodol. A week later, venography revealed another left iliac vein malformation embolized with foam sclerotherapy. Forty days later, the third angiography revealed another AVM in the right iliac artery, embolized with three vials of polyvinyl alcohol (PVA). Following two months of follow-up, the symptoms did not return.
CONCLUSIONS: The present study reported a rare case of recurrent pelvic AVM causing painless hematuria in a female patient. The lesion was treated with several angioembolization sessions.
CONCLUSIONS: Angioembolization is one of the main therapeutic options for AVM. Appropriate material should be precisely chosen for AVM embolization regarding the AVM\'s location, size, and condition.
摘要：
背景：动静脉畸形（AVM）导致动脉和静脉网络之间的直接连接，其中不涉及毛细血管分支。盆腔AVM是一种良性和罕见的疾病，会引起严重的疼痛，血尿,直肠或阴道出血.
方法：一名36岁女性，有5个月的血尿史。她的病史并不引人注目，实验室检查结果均在正常范围内.腹骨盆计算机断层扫描（CT）扫描显示左外侧骨盆有一个血管肿块，延伸到膀胱颈，并提示AVM。患者接受了剖腹手术切除AVM。第一次血管造影显示左髂内动脉有AVM。患者接受了线圈和凝胶泡沫栓塞。第二次血管造影显示由于右髂内动脉（RIIA）的多个线圈和AVM导致左髂内动脉完全阻塞，用胶水和碘油栓塞。一周后,静脉造影显示另一左髂静脉畸形经泡沫硬化治疗栓塞。四十天后,第三次血管造影显示右髂动脉有另一个AVM,用三瓶聚乙烯醇（PVA）栓塞。经过两个月的随访，症状没有恢复。
结论：本研究报告了一例罕见的复发性盆腔AVM，导致女性患者无痛性血尿。对病变进行了几次血管栓塞治疗。
结论：血管栓塞是AVM的主要治疗选择之一。应根据AVM的位置准确选择合适的材料进行AVM栓塞,尺寸,和条件。
方法：一名36岁女性，有5个月的血尿史。她的病史并不引人注目，实验室检查结果均在正常范围内.腹骨盆计算机断层扫描（CT）扫描显示左外侧骨盆有一个血管肿块，延伸到膀胱颈，并提示AVM。患者接受了剖腹手术切除AVM。第一次血管造影显示左髂内动脉有AVM。患者接受了线圈和凝胶泡沫栓塞。第二次血管造影显示由于右髂内动脉（RIIA）的多个线圈和AVM导致左髂内动脉完全阻塞，用胶水和碘油栓塞。一周后,静脉造影显示另一左髂静脉畸形经泡沫硬化治疗栓塞。四十天后,第三次血管造影显示右髂动脉有另一个AVM,用三瓶聚乙烯醇（PVA）栓塞。经过两个月的随访，症状没有恢复。
结论：本研究报告了一例罕见的复发性盆腔AVM，导致女性患者无痛性血尿。对病变进行了几次血管栓塞治疗。
结论：血管栓塞是AVM的主要治疗选择之一。应根据AVM的位置准确选择合适的材料进行AVM栓塞,尺寸,和条件。
