Fujimaki Hiroshi, Takeuchi Masaki
Department of Plastic and Reconstructive Surgery, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo, Chiba, Japan.
Plast Reconstr Surg Glob Open. 2019 Dec 12;7(12):e2535. doi: 10.1097/GOX.0000000000002535. eCollection 2019 Dec.
Acquired digital arteriovenous malformation (AVM) is a relatively rare form of AVM that occurs in the fingers. Together with a review of the literature, we report a rare case of acquired digital AVM that enlarged after pregnancy. The patient was a 32-year-old woman with the chief complaint of digital swelling accompanied by a burning sensation. During her pregnancy, the swelling of the fingers recurred, with a symptom of throbbing sensation. After giving birth, the swelling reduced but did not completely disappear. At the first visit, we observed purple discoloration and swelling of the ulnar aspect of the proximal interphalangeal joints of the left hand. Contrast-enhanced computed tomography scanning via the digital arteries of the left hand revealed a lesion showing early venous return, leading to the diagnosis of AVM. Surgery was performed under general anesthesia. The digital artery supplying the lesion was identified and dissected under a surgical microscope. At 15 months after surgery, there was no recurrence, sensory dysfunction, or mobility impairment.
获得性指动静脉畸形（AVM）是一种相对罕见的发生于手指的动静脉畸形。结合文献复习，我们报告一例罕见的获得性指动静脉畸形，其在妊娠后增大。患者为一名32岁女性，主要症状为手指肿胀伴烧灼感。在她怀孕期间，手指肿胀复发，伴有搏动性感觉症状。产后，肿胀减轻但未完全消失。初次就诊时，我们观察到左手近端指间关节尺侧呈紫色变色及肿胀。通过左手指动脉进行的对比增强计算机断层扫描显示一个病变呈现早期静脉回流，从而诊断为动静脉畸形。在全身麻醉下进行了手术。在手术显微镜下识别并解剖了供应病变的指动脉。术后15个月，无复发、感觉功能障碍或活动受限。
