title: A case with life-threatening uterine bleeding due to postmenopausal uterine arteriovenous malformation.
abstract: BACKGROUND
  Uterine arteriovenous malformation is a rare but life-threatening condition that accounts for 1-2% of massive vaginal bleeding. Uterine arteriovenous malformations are less common after menopause. The condition can be diagnosed using Doppler ultrasound, magnetic resonance imaging, computed tomography, and pelvic angiography.
  
  
  METHODS
  We report a postmenopausal patient with a uterine arteriovenous malformation who underwent emergency hysterectomy for sudden onset of life-threatening uterine bleeding following an initially successful but ultimately failed uterine artery embolization. Interestingly, it was not difficult to ligate and cut the dilated vessels and we were able to safely perform the hysterectomy with little bleeding in the operative field. The hysterectomy was successful, with most of the intraoperative vaginal blood loss due to the ruptured arteriovenous malformation. One year after surgery, the patient has had no vaginal bleeding.
  
  
  CONCLUSIONS
  We consider hysterectomy to be a comparatively safe and effective therapeutic option for postmenopausal women who suffered from uterine arteriovenous malformations with life-threatening uterine bleeding.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Enyacho 89-1, Izumo, Shimane, 6938501, Japan, prettynanaone@gmail.com.
authors.forename: Emi
authors.initials: E
authors.lastname: Sato
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakayama
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masako
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katagiri
authors.forename: Satoru
authors.initials: S
authors.lastname: Kyo
mesh_terms: D000792:Angiography; D001165:Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007083:Iliac Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017698:Postmenopause; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D055988:Uterine Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D055357:Uterine Artery Embolization; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery