Uterine hemorrhage in a menopausal female associated with an arteriovenous malformation and myometritis

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