Uterine hemorrhage in a menopausal female associated with an arteriovenousmalformation and myometritis

A case is described of vaginal bleeding in a 67-year-old female as the firs t manifestation of a uterine arteriovenous malformation (AVM). Although ble eding is the commonest presentation of an AVM, this is the first case known to have been precipitated by florid myometritis associated with the long-s tanding presence of an intra-uterine contraceptive device (IUCD). Uterine i maging studies utilising ultrasound scan with color Doppler were instrument al in suggesting the source of bleeding in this case. Subsequently, the pat ient suffered a torrential hemorrhage which necessitated hysterectomy.