Wednesday, 4 January 2012

An Unusual presentation of the vulva: A-V malformation

Arteriovenous malformation (AVM) is composed of large, tortuous arteries and veins. It is extremely rare presentation of the genital tract. There are not many data reported regarding AVMs in pregnancy, nor in non-pregnant ladies. Pregnancy can influence both the development and the progression of AVMs. It should be distinguished from vulvar varicosity, hematomas, neoplasm and other vascular anomalies. The bleeding tendency is unpredictable and many undergo spontaneous regression after delivery. We report on a 36 year old para 1, who was persistently having bilateral lower limbs venous varicosities and painful left vulvar swelling after her pregnancy. AVM was diagnosed with Magnetic Resonance Imaging (MRI) and venogram. She successfully underwent excision of the arteriovenous malformation and the ligation of the saphero-femoral junction. Histopathological examination confirmed the diagnosis. Post operative review at 3 month and 6 month, patient’s symptom improved and happy with the outcome.

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