The diagnosis of pelvic arteriovenous malformations (AVM) is suggested by careful clinical examination. A history of previous trauma, including surgery, is helpful in establishing the etiology. Angiography results in definitive diagnosis in these patients. This case will indicate the role of ultrasound in helping to establish the diagnosis and follow the progress of pelvic AVM. CASE REPORTA 44-year-old woman presented in 1975 with dyspnea on exertion, lower abdominal pain, and fatigue. No history of pelvic trauma or surgery was elicited. The diagnosis of pelvic AVM was considered. A femoral arteriogram showed bilatera1 multiple arteriovenous communications in the pelvic vasculature. She underwent a total abdominal hysterectomy, bilateral hypogastric artery ligations, and division of all branches of the hypogastric artery in an attempt to control the lesion.She was admitted to Emory University Hospital in December 1976 because of partial obstruction of the vesical neck. A gynecologic examination showed large pulsatile masses a t both the right and left vaginal walls.An intravenous pyelogram and cystogram revealed slightly irregular bladder margins with increased soft-tissue densities in the pelvis surrounding the filled bladder.An ultrasound examination performed on the same day showed multiple serpiginous sonolucent structures within the pelvis, with slight bladder compression. &nographical]y these structures have a consistent with vessels (Figs. lA, 1B).
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