Uterine arteriovenous fistula as a long-term complication of hysterectomy: Presentation and management

Background: A rare complication of hysterectomy is the formation of a high-flow fistula between the uterine artery and uterine vein. Historically, these lesions were treated surgically. Case: Two women with histories including hysterectomy presented with symptoms and physical examination signs suggestive of uterine arteriovenous fistulae. After arteriographic diagnostic confirmation, both women were treated successfully with endovascular embolization. Conclusion: A palpable, pulsatile pelvic mass in a patient with a history of hysterectomy should prompt referral for radiographic evaluation of a possible pelvic arteriovenous fistula. Selective arterial embolization may be considered an option for treatment of this entity.