Congenital Pelvic Arteriovenous Malformation with Massive Prostatic Hemorrhage: A Case Report

Abstract

Congenital arteriovenous malformations in the true pelvis are extremely rare: only 7 cases have been described in male patients. We report on a patient who presented with massive hemorrhage after transrectal prostatic biopsy and transurethral resection of the prostate. Diagnosis was established by means of magnetic resonance imaging and confirmed by arteriography. Our attempt at management by embolization and subsequent surgical ligation is described. A literature review and discussion of arteriovenous anomalies are presented.

A case of pelvic arteriovenous malformation in a male

“…Physical examination may reveal a pulsatile mass on digital rectal examination and a lower abdominal bruit. A pulsating mass was recognized in four cases and a bruit in three cases of the seven male cases reported in the English urological literature 1 –7 . In the Japanese literature, a pulsating mass was recognized in five and a bruit in four of the 10 male cases described.…”

“…In the Japanese literature, a pulsating mass was recognized in five and a bruit in four of the 10 male cases described. Unusual cases with hydronephrosis secondary to AVM in a female 9 and massive bleeding after transurethral resection 4 , 7 have been reported. Arteriovenous malformation may cause high output congestive heart failure and it was showed in nearly 20% of cases 10 …”

Management bei angeborener Gefäßmißbildung des männlichen Beckens

“…[4,6,7,10,12,17,19,20] wurden am häufigsten Hämaturien [2,6,9,10,13,14,16,18,20] und Potenzprobleme [5,7,10,12] beklagt. [4,6,7,10,12,17,19,20] wurden am häufigsten Hämaturien [2,6,9,10,13,14,16,18,20] und Potenzprobleme [5,7,10,12] beklagt.…”

“…Hierzu sind CT oder MRT gleichermaûen geeignet [16]. Hierzu sind CT oder MRT gleichermaûen geeignet [16].…”

“…1) zeigt, daû bei Erreichen der entscheidenden [6,21]. Bei ausgedehnten Gefäûmiûbildungen und Beteiligung von Beckenorganen wird daher die Indikation zur Embolisation mit Metallcoils und peripher einschwemmbarem Embolisationsmaterial gesehen [16]. Bei ausgedehnten Gefäûmiûbildungen und Beteiligung von Beckenorganen wird daher die Indikation zur Embolisation mit Metallcoils und peripher einschwemmbarem Embolisationsmaterial gesehen [16].…”