Intra-uterine use of a Foley balloon catheter to tamponade an actively bleeding post-traumatic uterine arteriovenous shunt

Arteriovenous shunts (AV-shunts) whilst rare, can complicate intrauterine surgical procedures leading to severe vaginal bleeding. We present the case of a 29-year-old woman who experienced sudden, torrential vaginal bleeding 10 days following a hysteroscopic resection and curettage of a placental remnant after vaginal delivery. Ultrasonographic evaluation with power doppler demonstrated a post-traumatic AV-shunt. Tamponading the shunt for 36 hours utilising an intra-uterine inflated Foley catheter successfully controlled the bleeding and led to complete resolution of the AV-shunt. Accurately differentiating an AV-shunt from other hyper vascular entities, such as enhanced myometrial vascularity or arteriovenous malformations, is essential, due to the important differences in therapeutic management strategies.