Due to the rarity of arteriovenous malformations (AVMs), there is a paucity of information on the outcomes of various treatments. Presently, the mainstays of treatment of an AVM are embolization, surgical excision or a combination of both. A retrospective study of 26 patients with AVMs treated at The Hospital for Sick Children, Toronto, Ontario between 1985 and 1995 was performed. The treatment strategies and patient outcomes were compared in terms of efficacy, complications and the response of patients and their families to their overall treatment. The overall findings showed that embolization alone was effective in controlling symptoms, but may be associated with an increased AVM size. A partial excision of an AVM does not appear to exacerbate recurrence, as has been previously reported. In fact, even after what appears to be a complete excision of the AVM, recurrence may still occur. Complications from a surgical excision of the AVM are more frequent but less devastating than complications from embolization of the lesion. The overall patient or parent satisfaction with treatment was high with respect to improvement in outcome. It is expected that with an increasing understanding of vascular malformations, and the evolution of interventional radiological techniques, complications will decrease and results as a whole will improve.

Arteriovenous malformation (AVM) of the urinary tract A 19-year-old woman was admitted with gross haematuria and fever; she reported a history of repeated wholeis uncommon; since the first case documented by Varela in 1928 [1], only 200 cases have been reported, mostly stream haematuria from the age of 9 years, and intermittent right loin discomfort associated with the attacks of of renal AVM, the cause being congenital or acquired. Kaplan et al.[2] reported the first case of ureteric AVM, haematuria. A general physical examination revealed marked pallor; her blood pressure was stable at the final diagnosis being made after excisional biopsy and fulguration of the ureteric nodule, later confirmed 130/80 mmHg. There was no organomegaly of the abdomen, no loin tenderness could be elicited and by histology. The present case is the second ureteric AVM in the English literature. Patients with this conabdominal bruit was not detected. Investigations confirmed microcytic and hypochromic anaemia (haemodition usually present with recurrent gross whole-stream globin 4.5 g/L); liver and renal function and the coagulation profile were all normal. Urine analysis confirmed haematuria, with a red blood cell count of>30 cells per high-power field, but urine cultures for infection and acid-fast bacilli were negative. A blood culture grew Enterococcus fecalis. Her condition improved with antibiotics and blood transfusion.Ultrasonography showed a right hydroureter and hydronephrosis that was confirmed with IVU, which also detected delayed excretion of contrast over the right side, but the level and cause of obstruction were not clear. Cystoscopy and right retrograde pyelography showed a tubular filling defect at the distal end of the right ureter. There were also multiple filling defects in the renal pelvis and the proximal right ureter which were compatible with blood clots (Fig.

Emphysematous cystitis (EC) is an uncommon but potentially life-threatening urinary tract infection. Diagnostic difficulty exists because of the variable presentations. We report the case of a 73-year-old woman who presented with diarrhoea and malaise, and emphysematous cystitis was revealed on the abdominal X-ray. As she was treated for EC, the diarrhoea and the radiographic abnormalities of EC also resolved. The evaluation and management of this complicated urinary tract infection are discussed.