Adnexal arteriovenous malformation presenting with spontaneous massive haemoperitoneum

Arteriovenous malformations (AVMs) are vascular anomalies composed of a tangle of abnormal vessels in which one or more feeding arteries are directly connected to one or more draining veins via a nidus with no intervening capillary bed. The adnexa are particularly rare sites for the formation of such malformations. Here, we present the case of a middle-aged woman who presented with spontaneous massive haemoperitoneum occurring as a result of a ruptured adnexal AVM. The diagnosis was suspected on transabdominal sonography and confirmed on CT angiography. The patient was shifted to the interventional radiology suite for an urgent angioembolisation following which she improved haemodynamically and her symptoms resolved. The case highlights the fact that although exceedingly rare, gonadal AVMs are an important cause of spontaneous intraperitoneal bleeding. Diagnostic and interventional radiology play an important role in the early and accurate diagnosis of this entity, and angioembolisation can be lifesaving in such patients.

Post-intervention complications and management: Following percutaneous catheter drainage

The role of an interventional radiologist in the care of the patent with pancreatitis is twofold - as a diagnostician and as an interventionalist. The diagnostic part includes the role in the diagnosis of pancreatitis, the possible etiology, and associated complications if any. From the therapeutic point of view it includes the management of the various vascular and non-vascular complications of pancreatitis. With increase in the percutaneous management of pancreatitis associated collections, it is prudent to be well versed with the complications that may be encountered. This article focusses on the various complications secondary to percutaneous management of collections in pancreatitis and the management options that are available at the interventional radiologist's disposal. The complications are discussed under different sections including access-related, catheter-related and other non-vascular complications.