Arteriovenous malformations
A 26 year old known case of idiopathic thrombocytopenic purpura on dapsone therapy with a recent history of medical termination of pregnancy followed by Mirena insertion presented with menorrhagia. Ultrasound study showed no evidence of intrauterine Mirena device and was suggestive of a possible arteriovenous (AV) fistula formation, which was likely acquired. CECT abdomen for further evaluation confirmed an arterial enhancing lesion (1.7 x 1.5 cm) in the myometrium of the anterior uterine body with multiple tiny vascular channels and draining vein suggestive of uterine AV malformation -with a feeder from right uterine artery, however the right uterine artery was not hypertrophied. No abnormal vascular channel was seen from left uterine artery and adnexa was normal. Right uterine artery embolisation was done and findings of tortuous right uterine artery with, prominent and abnormal leash of blood vessels noted. (Figure2). Following embolisation the symptoms resolved.