Zur klinischen Bedeutung arterio-venöser Shuntmißbildungen im Bereiche des inneren weiblichen Genitales

Abstract

This case report describes and discusses the entity of arteriovenous shunt malformations in the uterine and adnexal region. The diagnostic measurements and clinical importance of this disease is also outlined. The condition is rare, but should be considered in cases of severe hemorrhage when routine investigations have been normal. For the first time bloodgas-analytic measurements showing the extent of the shunting have been performed with such a disease.

Conservative Treatment of Uterine Arteriovenous Fistula

“…Arteriography was performed late, which delayed the correct diagnosis. Angiography should be carried out without delay in cases with a similar history (7, 11,15). Repeated curettages are contra-indicated, since they may induce life-threatening bleeding necessitating emergency operations including hysterectomy.…”

“…Uterine arteriovenous fistulas are a rarity. They are reported to be congenital or to develop as sequelae of pathological pregnancy, trophoblastic disease, or of trauma (1-5, 7, [9][10][11][12][13][14][15]17). Local symptoms are dominated by profuse bleeding.…”

“…Local symptoms are dominated by profuse bleeding. Large or long-standing fistulas are complicated by the general circulatory effects of blood shunting (4, 10, 15,17). The treatment reported in the literature has been hysterectomy.…”

Vaskuläre Malformation des Uterus

“…Degen erative Gefäßwa ndver änderungen und Gefäßektasie erklären sich aus eine m erhö hte n intraluminalen Druc k, dem betroffen e Venen durch die arteriovenöse Anastomose a usgesetzt sind . Dera rtige Gefäßverä nde rungen im Uterus si nd schon län ger beka nnt und wurden a uch als a rteriovenöses Häm an giom oder Aneurysma cirs oideum des Uterus besch rieben (7,11,16,17). Klinisch e rga b sich in unser em Fall kein Hinweis auf das Vorliegen eine r AV-Fiste l. Eine Angiogra phie, durch die die Diagnose zu siche rn gewesen wä re.…”