Progressive formation of uterine arteriovenous fistula after laparoscopic-assisted myomectomy.
BACKGROUND
Laparoscopic-assisted myomectomy (LAM) is a minimally invasive procedure with many advantages. However, progressive formation of uterine arteriovenous fistula (AVF) after LAM is not described as a significant complication.


METHODS
A 39-year-old nulligravida underwent LAM for multiple myomas. On ultrasonography obtained 13 days after LAM, a prominent vascular mass was identified in the post-myomectomy scar. Computed tomographic angiography showed AVF originating from the left uterine artery. Uterine AVF was endovascularly embolized by metallic coils to avoid future hemorrhage.


CONCLUSIONS
Development of uterine AVF after LAM is a potentially life-threatening complication. Early diagnosis and endovascular management can provide a significant benefit for a woman wishing uterine preservation.
Takeda
Akihiro
A
Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, 5-161 Maebata-cho, Tajimi, Gifu, 507-8522, Japan. gyendoscopy@gmail.com
Koyama
Kazuyuki
K
Imoto
Sanae
S
Mori
Masahiko
M
Sakai
Kotaro
K
Nakamura
Hiromi
H
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007889:Leiomyoma / Q000601:surgery; D011859:Radiography; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000098:blood supply*