Abstract
Introduction: Pulmonary arteriovenous malformation (PAVM) is a rare anomaly, mostly congenital, that tends to increase in size with the influence of various factors.
 Case report: A primigravida at 37 weeks of gestation presented with acute onset of dyspnea due to right sided hemothorax. Computed tomography showed abnormal vessels with pseudoaneurysm in the right lower lobe and shunting between subsegmental branch of right descending pulmonary artery and right inferior pulmonary vein. Embolization of the lesion was planned after immediate cesarean section. Coil embolization with complete occlusion of supplying artery of the lesion was done.
 Conclusion: PAVM, although rare can result in fatal complications if untreated. Less invasive image guided coil embolization is a promising treatment modality.
Highlights
Pulmonary arteriovenous malformation (PAVM) is a rare anomaly, mostly congenital, that WHQGVWRLQFUHDVHLQVL]HZLWKWKHLQÀXHQFHRIYDULRXVIDFWRUVCase report: A primigravida at 37 weeks of gestation presented with acute onset of dyspnea due to right sided hemothorax
PAVM, rare can result in fatal complications if untreated
Immediate chest X-ray Posterior-Anterior view (PA view) was done which showed opaque right KHPLWKRUD[VXJJHVWLQJULJKWSOHXUDOH൵XVLRQ3OHXURFHQWHVLV was done in emergency department, which revealed KHPRUUKDJLF H൵XVLRQ &RQWUDVW HQKDQFHG FRPSXWHG tomography (CT) with CT angiography was done which showed vascular malformation with pseudoaneurysm formation in the lower lobe of the right lung
Summary
Pulmonary arteriovenous malformation (PAVM) is a rare DQRPDO\ ZLWK ORZUHVLVWDQFH EXW KLJK ÀRZ DQRPDORXV vessels due to abnormal communication between pulmonary arterial and venous systems with bypass of the capillary bed. Various other terminologies have been used IRU3$90OLNHSXOPRQDU\DUWHULRYHQRXV¿VWXODSXOPRQDU\ arteriovenous aneurysm and pulmonary angiomas. Most of these lesions are congenital malformations and acquired lesions are extremely uncommon.[1] They tend to increase LQ VL]H ZLWK LQÀXHQFH RI YDULRXV IDFWRUV OLNH SXOPRQDU\ arterial hypertension, puberty and pregnancy.[2]. Immediate chest X-ray Posterior-Anterior view (PA view) was done which showed opaque right KHPLWKRUD[VXJJHVWLQJULJKWSOHXUDOH൵XVLRQ3OHXURFHQWHVLV was done in emergency department, which revealed KHPRUUKDJLF H൵XVLRQ &RQWUDVW HQKDQFHG FRPSXWHG tomography (CT) with CT angiography was done which showed vascular malformation with pseudoaneurysm formation in the lower lobe of the right lung. As the patient was stable following the cesarean section, conventional pulmonary angiography with embolization was planned one-week post-partum
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