UTERINE AVMS WITH MYOMETRIAL PSEUDOANEURYSM

A young female with early pregnancy had h/o D&C done . She then developed excessive bleeding PV for 1 month. 

This case was evacuated with TVS ....showed some retained products of conception, & multiple vascular cystic areas in juxtaposed myometrium with mosaic Color flow signals on Doppler. A large rounded unilocular  intramural cystic mass was also noted anteriorly which showed color signals , s/o- pseudoaneurysm ( fig 1 to 4 ) . 

Fig 1- TVS sag scan shows some retained products in endometrial cavity &  a large round ed cystic mass in anterior uterine wall with mobile low level int. echoes . 

Fig 2- TVS transverse scan shows myometrial cyst 

Fig 3- TVS color Doppler scan Shows central RPOCs . Multiple anterior & posterior uterine wall vascular channels , s/o AVMs . The large anterior cystic mass with color flow indicative of pseudoaneurysm.

Fig 4 - TVS color Doppler TUI images depicting uterine AVMs & pseudoaneurysm  . 

Post gestational uterine AVMs are encountered in gynecological practice, but associated myometrial pseudoaneurysm is a rare entity . 

PS : 1) CASE & images courtesy- Dr Renu Sharma - Radiologist ( Sikar, Rajasthan , India)

2) The case study is intended for imaging specialists & medical practitioners for academic purpose only.

3) It needs further discussion & review of literature