Fujita Munezumi, Yamamoto Yuhei, Sasaki Satoru, Oyama Akihiko, Funayama Emi, Furukawa Hiroshi
*Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University †Center for Vascular Anomalies, Tonan Hospital, Sapporo, Japan.
J Craniofac Surg. 2017 Oct;28(7):e675-e678. doi: 10.1097/SCS.0000000000003829.
Patients with arteriovenous malformations (AVMs) are at risk of significant hemorrhage and AVMs are especially difficult to manage in those desiring future pregnancy. Few patients with successful deliveries have been previously reported.The authors report an unusual case of AVM of the tongue in a pregnant woman who presented with massive pulsatile bleeding from a ruptured artery in the tongue in late gestation, this was thought to be caused by the changes in hormonal balance and the increase in cardiac output. The bleeding was controlled with transarterial embolization and transmucosal absolute ethanol sclerotherapy. Furthermore, her second and third deliveries were successfully managed.The authors managed symptomatic tongue AVM by combining transarterial embolization and transmucosal sclerotherapy, which was followed by successful deliveries. This patient supports the utility of transmucosal absolute ethanol sclerotherapy for tongue AVM and multidisciplinary medical care for a successful delivery.
患有动静脉畸形（AVM）的患者有发生严重出血的风险，对于那些希望未来怀孕的患者而言，AVM尤其难以处理。此前鲜有成功分娩的患者报道。作者报告了一例罕见的孕妇舌部动静脉畸形病例，该孕妇在妊娠晚期因舌部动脉破裂出现大量搏动性出血，认为这是由激素平衡变化和心输出量增加所致。出血通过经动脉栓塞和经黏膜无水乙醇硬化疗法得到控制。此外，她的第二次和第三次分娩均顺利进行。作者通过联合经动脉栓塞和经黏膜硬化疗法成功处理了有症状的舌部AVM，随后实现了成功分娩。该患者支持经黏膜无水乙醇硬化疗法治疗舌部AVM以及多学科医疗护理以实现成功分娩的实用性。
