Abstract

Background: Uterine curettage after spontaneous pregnancy loss may result in complications, including acquired arteriovenous fistula (AVF), and most cases settle spontaneously with conservative or medical management. Persisting symptoms require more definitive treatment and this is usually with hysterectomy. This report shows that the embolization as a uterine-sparing surgical alternative can offer a definitive endovascular treatment strategy.
Case presentation: A 34-year-old lady presented with anemia from recurrent per-vaginal bleeding which persisted for 3 months after curettage for failed early pregnancy. Ultrasound showed AVF and a large pseudoaneurysm. Angiography and embolization was performed using gelatin sponge which was able to successfully treat the vascular lesions. At 2 years follow-up, she had complete symptom resolution and preserved her uterus.
Conclusion: There are only a small number of case reports in the literature to support embolization as a minimally invasive surgical alternative as a definitive treatment.

Key words: Case report, bleeding, fistula, AVF, pseudoaneurysm, hysterectomy, embolization