Cornual ectopic pregnancy in a female with initial negative ultrasound

Acquired uterine arteriovenous malformation in a patient with cornual pregnancy: A case report

INTRODUCTION

Acquired uterine arteriovenous malformation (uAVM) is a rare disease and could occur after dilation and curettage, cesarean section, or neoplastic processes.

PATIENT CONCERNS

A 29-year-old female presented with acute right lower abdominal pain and positive beta human chorionic gonadotropin (β-hCG).

DIAGNOSIS

A 6 cm ectopic right cornual pregnancy was found on ultrasound examination.

INTERVENTIONS

She underwent a laparoscopic resection of the cornual ectopic pregnancy. She returned with extensive vaginal bleeding 6-month post surgery, and eventually diagnosed with arteriovenous malformation at the previous surgical site by Color Dopplor endovaginal ultrasound. Percutaneous transcatheter uterine artery embolization (UAE) was attempted, however, vaginal bleeding continued. She was taken to the operation room for a hysteroscopic ablation of uAVM.

OUTCOMES

Complete cessation of the bleeding was achieved without hysterectomy.

CONCLUSION

We report an extremely unusual case of acquired uAVM after a wedge resection of cornual pregnancy. Ultrasound evaluation of patients with post-operative persistent bleeding should be considered for evaluation of a possible arteriovenous malformation.