DOI: 10.36347/sjmcr.2018.v06i08.014

Pages: 541-544

Pelvic arteriovenous malformations (AVMs) are the result of shunting blood from arteries to low resistance veins, and represent a rare challenging lesions especially in male patients. Diagnosis is orientated by clinical findings and confirmed by medical imagery tools, though selective arteriography remains the gold standard tool for diagnosis. Treatment choices differ from surgical to percutaneous procedures, or hybrid intervention with the combination of a preoperative embolization and surgery. We report a case of a 33 years old with an enormous pelvic AVMs revealed by a high output heart failure, which we treated with transarterial embolization using gelatine sponge particles, complicated later on, with rectal ischemia enabling us not to proceed to the second stage of the planned therapeutic strategy by venous approach. AVMs are vascular lesion that is notoriously difficult to diagnose and treat, and it is a clinical dilemma to make the best treatment choice from surgery to embolization in symptomatic patients, with no evidence supporting the superiority of one over the other.