Bilateral Pulmonary Arteriovenous Malformations: Challenges in a Rare and Complex Case

Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular connections between the pulmonary arteries and pulmonary veins. Despite their relatively uncommon incidence, PAVMs should be considered in the differential diagnosis of children presenting with cyanosis due to the life-threatening complications posed by paradoxical emboli. The primary management approach involves eliminating the abnormal connections, either through surgical or endovascular methods. We present a case of a five-year-old boy who was seen in the Outpatient Department with cyanosis of the lips and nail beds persisting for eight months. On examination, grade 3 clubbing was noted. Imaging and subsequent angiography revealed multiple bilateral diffuse AVMs, which were treated using an endovascular approach.