Curettage Research Articles

Riga–Fede disease in association with natal teeth

The purpose of this paper is to report a case of a 16-day-old infant with two natal teeth in mandibular anterior region associated with ulceration on the tip and ventral surface of the tongue. Clinical presentation revealed two natal teeth with Grade II mobility in the mandibular anterior region and Riga–Fede Disease. The treatment planned was to extract both the natal teeth followed by curettage of the extraction socket to prevent aspiration, swallowing of teeth, and for early resolution of ulcerative lesion. Satisfactory healing of ulcerative lesion was observed at 10 days follow-up visit.

Expectant therapy versus curettage for retained products of conception after second trimester termination of pregnancy: analysis of outcomes and complications

To evaluate the prognosis and complications of expectant therapy and curettage for retained product of conception (RPOC) after second trimester termination of pregnancy (TOP). A total of 270 patients with RPOC following second trimester TOP in Nanfang Hospital between January, 2014 and December, 2015 were included in this study. The duration of vaginal bleeding time and menstruation recovery interval were compared between patients receiving expectant therapy and curettage for RPOC, and binary logistic regression was used to assess the risk factors for complications in bivariate and multivariate analyses. The duration of vaginal bleeding time was significantly longer in expectant therapy group than in curettage group (P=0.005), while the menstruation recovery interval did not differ significantly between the two groups. The incidence of vaginal bleeding time for over 42 days was significantly higher in curettage group than in expectant therapy group (P=0.040), and the incidence of a menstruation recovery interval beyond 60 days was comparable between them. The incidence of complications was significantly higher in curettage group than in expectant therapy group either with adjustment of age, gravidity, parity, history of uterine surgery status, gestational age, type of indications, regimens for TOP and induction-abortion interval (OR=18.26 [95% CI: 3.57-93.42], P<0.001) or without adjustment (OR=10.60, [95% CI: 2.36-47.66], P=0.002). Expectant therapy and curettage for RPOC after second trimester TOP have comparable prognosis, but curettage is associated with a significantly higher rate of complications.

Observation of effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps

Objective To explore the clinical effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps. Methods 126 patients with abnormal uterine bleeding of endometrial polyps were selected, and they were selected and randomly divided into control group and research group according to the digital table, 63 cases in each group. The control group received traditional curettage surgery, the research group received hysteroscopic eletrosurgery. The intraoperative blood loss, operative time, length of hospital stay, postoperative menstruation recovery time, therapeutic effect and complications were compared between the two groups. Results The intraoperative blood loss and operation time of the research group were significantly lower than those of the control group (t1=7.44, P1<0.01, t2=7.78, P2<0.01). And there were no statistical differences between the two groups in length of hospital stay and postoperative menstruation recovery time(t1=1.82, P1=0.07, t2=1.71, P2=0.09). The total cure rate of the research group was 100.00%, which of the control group was 92.14%, the difference was statistically significant(χ2=8.18, P=0.00). The incidence rate of complications of the research group was 3.17%, which of the control group was 17.50%, the difference was statistically significant(χ2=11.08, P=0.00). Conclusion Hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps has remarkable clinical effects and low incidence of complications, and it is worthy of clinical application. Key words: Hysteroscopy; Endometrial polyps; Uterine hemorrhage

The analysis of cases with eye injury caused by mineral spirits

Objective To analyze the treatment and prevention of eye injury caused by mineral spirits vapour. Methods Ten eyes of 6 cases with eye injury caused by mineral spirits vapour were given saline thoroughly rinsing the conjunctival sac. Nine eyes of 5 cases received corneal epithelial curettage combined with bandage contact lens; one eye of 1 case was underwent amniotic membrane transplantation first, and then accepted the combined surgery. The changes of endothelial cells were observed postoperatively. Results Except 2 eyes of 1 case with corneal endothelial decompensation, 8 eyes of 5 patients were cured. Their corneal fluorescein staining not colored, and restore transparency, no clouds form, vision returned to normal and corneal endothelial cells without significant change. Conclusion Mineral spirits vapour can induce corneal epithelial degeneration and endothelial damage. Corneal epithelial scrape combined with bandage contact lens is effective treatment for mineral spirits injury and can significantly shorten the healing time of corneal epithelium. Key words: Mineral spirits, volatile; Corneal injury , chemical burn; Treatment

Clinical application value of endometrial collector combined with liquid based cytology and histological examination for screening of endometrial cancer

Objective To analyze the clinical application value of endometrial collector combined with liquid based cytology and histological examination for screening of endometrial cancer. Methods One hundred and eighty-two cases high-risk people with endometrial cancer in Songgang People's Hospital of Bao'an district of Shenzhen from June 2014 to December 2015 were collected, among them 71 patients with endometrial cancer were found in the patients who were diagnosed by pathological diagnosis, and the remaining 111 were not diagnosed with endometrial cancer.The material satisfaction, sample collection time of sample collection and endometrial curettage device were comparatively analyzed and also the cervical dilatation production rate, the amount of bleeding, pain score(VAS) were analyzed.The application value of endometrial collector combined with liquid based cytology and histological examination for screening of endometrial cancer was judged according to the results obtained. Results There was no significant difference between the two methods based on satisfaction(χ2=1.953, P=0.089). A methods of cervical endometrial expansion rate(3.85% vs.93.96%) and acquisition time((16.35±2.19) min vs.(11.23±4.26) min), bleeding volume((1.64±0.63) ml vs.(15.73±5.41) ml), VAS score((0.82±0.24) points vs.(4.34±2.43) points) were significantly lower than that of curettage sample collection method(χ2=16.473, P=0.000; t=5.733, P=0.034; t=11.183, P=0.000; t=3.618, P=0.043). With curettage pathological diagnosis as the gold standard, the specificity, sensitivity and diagnostic coincidence rate of endometrial biopsy combined with liquid based cytology and histological examination for screening endometrial carcinoma were respectively 94.51%, 95.05% and 94.96%. Conclusion Compared with curettage sampling method, endometrial curettage collector has features of high success rate, short time, low pain and high security and the cervical dilation rate is low.Endometrial curettage collector can be combined with liquid based cytology and histology to examine and screen endometrial cancer.This methods is worth promoting. Key words: Endometrial collector; Liquid based cytology; Histology; Endometrial carcinoma; Clinical value

Value of 18F-FDG PET/CT SUVmax for preoperative assessment of primary tumor infiltration and metastases in patients with endometrial cancer

Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer. Methods A retrospective study was performed in 51 patients (average age (59±12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015. Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging. With SUVmax as the statistical variable, comparison was made between the pathologically confirmed benign and malignant groups, and in case of the latter, the extent of infiltration, histologic grade and subtype of primary tumor, lymph node and distant metastases were also analyzed. Two-sample t test was used to analyze the data, and diagnostic efficacy of PET/CT for metastasis was calculated. Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor. SUVmax was found to significantly correlate with histopathology classification (benign: 3.4±1.2, malignant: 12.8±6.5) and depth of myometrial invasion (≥1/2: 17.7±5.4, 0.05). The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7%(18/21), 98.2%(271/276), 97.3%(289/297), 78.3%(18/23), 98.9%(271/274), respectively, and on a patient basis were 6/6, 97.3%(36/37), 97.7%(42/43), 6/7, 100%(36/36), respectively. The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12. Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion, lymph node metastases and other metastases in patients with endometrial cancer, particularly in specificity and NPV. Key words: Endometrial neoplasms; Neoplasm metastasis; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

Intralesional Infiltration with Triamcinolone for the Management of Giant Cell Central Granuloma

The central giant cell granuloma is a benign lesion on the jaws, which etiology is not yet known exactly. It has preference for young adults and female gender populations; it has predilection for jaws. Among the treatment options there are the infiltration of various solutions, curettage and resection in-bloc; the latter indicated in aggressive cases. This article presents an aggressive case of central giant cell granuloma treated; it was an 11 year-old-male patient treated with triamcinolone acetonide intralesional injections during 6 weeks followed by surgical enucleation; a 14 month follow up after the treatment was finished, with no recurrence signs.

A retrospective analysis of patients treated for gestational trophoblastic diseases: a 4-year experience of a tertiary hospital.

To study incidence, clinical outcome, and follow-up data of the gestational trophoblastic disease (GTD) in patients diagnosed in the present Department. This study included the authors' retrospective clinical records regarding the cases of GTD which were diagnosed and followed up between January 2011 and January 2015. Patients' age, gravidity and parity, obstetric history, subgroup of GTD, gestational weeks, management results, and pre-post treatment β-hCG levels was investigated and an incidence study was constituted. Total of 56 GTD cases were hospitalized and clinical records of 16,840 normal spontaneous deliveries were evaluated during the study period. The incidence of GTD was 3.3/1,000 cases. After histopathological examination, nine of 47 cases were partial molar pregnancy, whereas 38 cases were complete moles. There were no choriocarcinoma and invasive moles. All cases were treated with vacuum curettage without complication. The GTD incidence in this clinic is high with a rate of 3.3/1,000 per pregnancy compared to Turkish literature. High birth rates of our population may play a role in high incidence results. Further investigation in this field is essential.

Diagnostic value of transvaginal color Doppler ultrasound on endometrial lesions.

To discuss the diagnostic value of transvaginal color Doppler ultrasound on endometrial lesions. The study included 126 cases diagnosed with endometrial lesions by transvaginal color Doppler ultrasound that were examined by hysteroscopy, biopsy, and curettage pathology, and compared with pathology. The transvaginal color Doppler ultrasound diagnosis corresponded to 92.6% (117 of 126 cases) of the pathology diagnosis. Transvaginal color Doppler ultrasound has important diagnostic value in the case of endometrial lesions, has a high rate of detection and diagnostic on endometrial lesions, and is the best method for diagnosis of endometrial lesions.

Resection and functional reconstruction of pelvic tumors

Objective To discuss the method of resection and reconstruction and effects in pelvic tumors. Methods The data of 27 cases with pelvic tumors treated with limb-salvage surgery during January 2005 to September 2015 were retrospective analyzed, including 15 males and 12 females, with age from 12 to 78 years old. Among these cases, there were 10 benign tumors, 1 borderline tumor, 14 malignant tumors and 2 metastatic tumors derived from other primary tumors. According to Enneking's division, it was consisted of 14 cases in region Ⅰ, 2 cases in region Ⅱ, 6 cases in region Ⅲ, 2 cases in region Ⅰ+Ⅱ, 1 cases in region Ⅱ+Ⅲ and 2 cases in region Ⅰ+Ⅳ. Excision or curettage were chosen for benign tumors, and bone grafting or bone cement filling internal fixation were also used if necessary. For borderline and malignant tumors, radical resection was performed, meanwhile, reconstruction was done when pelvic ring continuity or acetabulum was destroyed, and palliative surgery was performed in some patients. All of them were followed-up 4-125 months. Results There was no perioperative death. Among 10 benign patients, 1 case (10.0%) of local recurrence was found. 8 (47.1%) patients in 17 borderline and malignant patients were dead, including 5 cases(29.4%) dead of local recurrence, 2 cases(11.8%) dead of uncontrolled lung metastasis and 1 case(5.9%) dead of primary disease. According to Kaplan-Meier method, the 1-, 2-, 3- and 5-year survival rates of borderline and malignant patients were 75.6%, 61.9%, 43.3% and 43.3%, respectively. As for the functional recovery, the lower-limb fuction of patients treated by resection or reconstruction in region Ⅰ, Ⅲ or Ⅳ got basically recovered, and the patients in region Ⅱ needed one crutch to assist walking. Conclusion Selecting suitable resection or reconstruction methods according to the histology and the location of pelvic tumors can get favorable effects, furthermore, surgical methods need to individualize. Key words: Bone neoplasms; Pelvic; Limb-salvage treatment; Reconstruction

Initial gingival tissue attachment to the deep cementum.

This study was performed in order to obtain fundamental knowledge regarding gingival connective tissue response to cementum. Gingival tissues of monkeys were elevated, and superficial cementum only was curetted. The time course of initial gingival tissue attachment was subsequently examined by conventional histology and also by electron microscopy. The first response was inflammatory exudate and fibrin attachment followed by granulation tissue formation. Cementoblasts were observed along the curetted cementum surface in the 10-day specimen. Mature collagen fibrils accumulated between the cementoblasts and the cementum surface in the 14-day specimen. We conclude that curetting the superficial cementum from root surfaces facilitates the formation of the fibrous connective tissue attachment.

Clinical analysis of hyponatremia during hysteroscopy

From November 2013 to November 2015 among 3 410 patients underwent hysteroscopy in our hospital, 14 developed hyponatremia during operation, and the incidence was 0.41%.Among 311 patients underwent hysteromyomectomy, 8 developed hyponatremia during operation, and the incidence was 2.6%.Among 476 patients underwent endometrectomy, 1 developed hyponatremia during operation, and the incidence was 0.2%.For the 8 patients underwent curettage, 62 patients underwent trans-cervical resection of adhesion and 11 patients underwent trans-cervical resection of uterine septa, the incidence of intraoperative hyponatremia was not calculated because the number of patients was less than 100.All the 14 patients with hyponatremia suffered from severe gynecological diseases or were diagnosed with a larger volume of lesion.Among the patients developing hyponatremia during hysteromyomectomy, 4 presented with large submucous myomas (maximum diameter≥3 cm), and 4 presented with medium-sized submucous myomas (1 cm≤maximum diameter≤3 cm); the maximum diameter of the intrauterine residue >2.5 cm in 2 patients, endometrial thickness was found in 1 patient, 2 patients were diagnosed with severe intrauterine adhesions, and the last one was a complete septate uterus.The duration of operation was (92±43)min, irrigation fluid deficit was 2 200(4 000)ml, and irrigation fluid pressure was 120(40) mmHg, which were higher than the level of the corresponding parameters in routine hysteroscopy.Hemodynamic instability (changes in blood pressure and heart rate >20% of the baseline value) and severe hypoxia (SpO2 95%). One patient did not develop hemodynamic instability or hypoxia.Blood natrium, potassium, chloride, calcium ion, hemoglobin and hematocrit were significantly lower during operation and on the right postoperative day than before operation (P<0.05). Blood natrium returned to normal after treatment with furosemide and/or 1%-3% sodium chloride, and no permanent neurologic damage was found in all the patients.In conclusion, hysteroscopic hyponatremia was affected by factors such as surgical type, lesion size, surgical time, irrigation fluid deficit and pressure, and the major clinical manifestations included neurological abnormalities and fluid overload. Key words: Hyponatremia; Intraoperative complications; Hysteroscopy

The utility of routine endocervical curettage at the time of colposcopy for low-grade cytologic abnormalities to improve diagnosis of high-grade diseases

Objective: To determine the use of endocervical curettage(ECC) at the time of colposcopy for low-grade cytologic abnormalities to improve the diagnosis of high-grade diseases. Materials and methods: A prospective diagnostic study was conducted. We included women with low-grade cytologic abnormalities: low-grade squamous intraepithelial lesion (LSIL) who had undergone colposcopy at Chonburi Hospital between January 2014 to March 2015. Data collected were age, menopausal status, HIV status, parity, contraception, colposcopic findings and pathological report of biopsy and ECC. Main outcome measure: Primary outcome was the increasing rate of ECC in colposcopy for LSIL to detect high-grade lesion. Result: Eighty-seven women met criteria. Nine cases (10.3%) were ECC positive for high-grade lesion. Of these nine cases, seven cases were only ECC positive, resulting in 8.04% increased detection with ECC independently of biopsy, with a sensitivity of 20.0%, specificity of 91.91%, positive predictive value of 22.22% and negative predictive value of 89.74%. Therefore, twelve to thirteen ECCs needed to be performed to detect one case of high-grade diseases. Among post-menopausal women or women older than 40 years old, the sensitivity of ECC improved, with a sensitivity of 100% and 85% respectively. Conclusion: The increased detection rate of ECC to detect high-grade lesions in women who had low-grade cytological abnormalities in our study was 8.04%. Routine ECC at the time of colposcopy for LSIL in young women is debatable. However, the sensitivity of ECC was found to be increased in women aged over 40 and post-menopausal women. Therefore, ECC may be useful in older and post-menopausal women.

Bilateral decompression via unilateral fenestration and interbody fusion for complex lumbar spinal stenosis with mobile microendoscopic discectomy technique

Objective To evaluate the feasibility and clinical efficacy of bilateral decompression via unilateral fenestration and interbody fusion for complex lumbar spinal stenosis with mobile microendoscopic discectomy (MMED) technique. Methods Sixty-eight complex lumbar spinal stenosis patients with an average age of 67 years old (range, 56-76), including 39 men and 29 women, were treated by this procedure using MMED technique. Among them, 49 and 19 of these patients had degenerative spondylolisthesis and scoliosis respectively. All patients complained of lumbar or leg pain combined with intermittent claudication, and the index levels L4, 5 involved in 57 patients, L5S1 in 6 patients, L3-L5 in 4 patients and L4-S1 in 1 patient. Pre-operative Oswestry disability index (ODI) was 43.8%±10.4%, visual analogue scale (VAS) 6.3±3.3 for lumbar pain, and 6.1±3.8 for leg pain. Through a 2.5-3.5 cm incision medial to puncture sites of pedicle, unilateral fenestration and bilateral decompression was performed under MMED, and the disc space was curetted and prepared adequately. The inner tube was removed, and the disc space was released, tested and grafted, followed by suitable cage, whose position was confirmed under fluoroscopy. Percutaneous transpedicular screws were installed under fluoroscopy, followed by reduction and fixation. The operative time and blood loss were recorded, and the patients were followed to evaluate the clinical results. Results Surgery was successful in all patients, without nerve injury or conversion to open surgery. The mean operative time was 120 min (range, 100-180 min), with a mean blood loss of 100 ml (range, 50-200 ml). The post-operative X-ray and CT scans showed sufficient decompression and improvement of spinal alignment, with the ratio of spondylolisthesis improved from 17.9±6.2 to 11.8±4.8. All patients were followed up for more than 6 months, while 61 of them were followed for 12-24 months, with ODI score of 8.9±7.4, VAS of lumbar 1.2±1.1 and VAS of leg 0.9± 0.9 at final follow-up, that were significantly decreased compared to pre-operative scores. The clinical results were excellent in 41 cases, good in 25, and fair in 2 based on the MacNab scale. Conclusion Complex lumbar spinal stenosis can be treated by bilateral decompression via unilateral fenestration and interbody fusion with MMED technique. This procedure can also provide satisfactory results in short-term follow-up. Key words: Lumbar vertebrae; Spinal stenosis; Decompression, surgical; Spinal fusion; Surgical procedures, minimally invasive

Should we be bothered with asymptomatic endocervical polyps in perimenopausal women

Cervical polyps are defined as focal hyperplastic protrusions of endocervical folds with an incidence of 1%-10%. The majority of endocervical polyps are benign and the incidence of high-grade squamous intraepithelial lesion (HSIL) or carcinoma is relatively rare (1: 1000). Endocervical polyps are mostly incidentally discovered, however the most frequent symptoms are post-coital, postmenopausal or intermenstrual bleeding and/or profuse discharge. Here, we present a perimenopausal women with an asymptomatic polyp, later to be diagnosed with cervical carcinoma. A 46-year-old woman applied to our outpatient clinic without any complaint. The examination revealed a 2.3x2 cm cervical polyp with a slim pedincule. An immediate cervical polypectomy was performed and histopathological examination was resulted as HSIL. The patient then underwent cold-knife conization and endocervical curettage (ECC). The excized cone material’s histopathology was consistent with the polyp and the cervical lesion was continous at the surgical borders. ECC was positive for cervical intraepithelial changes. A type 1 hysterectomy was carried out. The definitive pathological diagnosis was microinvasive squamous carcinoma. Accummulating literature advises against routine polypectomy, despite the possibility of displasia in cervical polyps. Various clinical aspects, such as symptoms, age, menopausal status, cytological and colposcopic findings have been evaluated in conjunction with this common entity. In conclusion, the gen- eral notion that symptomatic polyps over 5 mm should be evaluated may be cost-effective, but will not discern cases of polyp associated operable microin-vasive /invasive cervical carcinomas.

Endometrial patterns in abnormal uterine bleeding

Background: Abnormal utrerine bleeding is the direct cause of significant health burden for women. Examination of endometrial biopsy is a challenge to pathologists , due to wide range of morphologic patterns. Aims and objectives: The present study was undertaken in cases of abnormal uterine bleeding and to correlate it with the clinical condition. Method: Atotal of 212 cases were included either by endometrial curettage or hysterectomy. Results: Major age group was 40-49 years. Menorrhagia was the commonest bleeding pattern. DUB was the largest group as regards the clinical diagnosis. Overall proliferative endometrium was the commonest histopathologiacal picture also it was the commonest picture of patients presenting with different bleeding patterns except of postmenopausal bleeding where atrophic endometrium was the commonest histological picture. Consistancy rate between curettage and hysterectomy was 56.25%. Conclusion: Abnormal uterine bleeding is a common debilitataing in women. Correct and timely diagnosis is necessary and specially to rule out cases of hyperplasia and carcinomatous focus for proper and timely management of patients.

Immunoexpression of Cyclin D1 and PTEN in Various Endometrial Pathologies.

To determine the expression of cyclin D1 and PTEN (phosphatase and tensin homolog) in endometrial hyperplasias and neoplasias. Analytical study. The study was conducted at BMSI, JPMC, Karachi, from January 2008 to December 2012. Analysis of endometrial samples, comprising of hysterectomies and curettage, was carried out. Immunohistochemical staining was done for PTEN and cyclin D1 expression. Fifty-three endometrial samples including 23 endometrial carcinomas, 6 complex hyperplasias with atypia, 14 complex hyperplasias without atypia, 6 simple hyperplasias without atypia and 4 normal proliferative endometrium were analyzed. Fifty-two percent (12 out of 23) and 48% (11 out of 23) cases of endometrial carcinomas showed complete loss of PTEN expression and cyclin D1 over expression, respectively. Five (5 out of 6) cases of complex hyperplasias with atypia and 64.28% (9 out of 14) cases of complex hyperplasia without atypia showed complete loss of or diminished expression of PTEN whereas 66.66% (4 out of 6) cases of endometrial hyperplasia with atypia and 50% (7 out of 14) cases of endometrial hyperplasia without atypia showed cyclin D1 overexpression (p &amp;lt; 0.001). Loss of PTEN, expression and cyclin D1 overexpression was seen in a significant number of well differentiated endometrial adenocarcinomas and complex hyperplasias with atypia, suggesting both as an early event in endometrial carcinogenesis.

Comparison of Sublingual and Vaginal Misoprostol for Cervical Ripening before Curettage: A Randomized Controlled Trial

Objective: To compare the effectiveness and side effects of misoprostol as a cervical ripening agent through two different routes of administration before curettage. Materials and Methods: The study employed a hospital based prospective randomized controlled trial. A total of 70 patients were simple random divided in two groups for 400 micrograms sublingual and vaginal administration. The drug was administered 6 hours before dilatation and curettage or fractional curettage. Efficacy was assessed on cervical dilatation achieved, pain score and vaginal blood loss. The tolerable limit was noted based on side effects. Results: The sublingual group had significantly more cervical dilatation than the vaginal group (median cervical dilatation 7 mm vs. 5 mm, P < 0.001). Significantly less pain scores (VAS) in sublingual group than vaginal group (3.3 vs. 4.8, P < 0.001). Postoperative vaginal blood loss in the sublingual group was significantly greater than the vaginal group (20 ml vs. 10 ml, P < 0.001). Other side effects such as fever, chill, nausea, vomiting and diarrhea did not differ in both groups. Conclusion: Sublingual misoprostol could be more effective for cervical dilatation, but presents greater postoperative vaginal blood loss than vaginal route.

An Unusual Case of Acquired Uterine Arteriovenous Malformation With Persistent Scar Ectopic Pregnancy Successfully Managed With Uterine Artery Embolization

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology, with fewer than 100 cases reported in the literature. AVM is an abnormal arteriovenous connection lacking an intervening capillary network on histopathological examination. We report an unusual case of acquired AVM after dilatation and curettage of cesarean scar ectopic pregnancy managed with uterine artery embolization and concurrent methotrexate administration for persistently elevated beta-human chorionic gonadotropin levels. J Med Cases. 2016;7(4):143-147 doi: http://dx.doi.org/10.14740/jmc2458w

Cesarean scar pregnancy: role of serial transabdominal ultrasonography in the diagnosis and treatment response following dilation and curettage.

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