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J Korean Soc Emerg Med > Volume 29(1); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(1): 93-99.
Life-threatening Hemorrhage Caused by Mandibular Arteriovenous Malformation: A Case Report
Dong Wook Kim1, In Suk Sol1, Min Jung Kim1, Soo Yeon Kim1, Jong Deok Kim1, Bong Seok Choi2, Yoon Hee Kim1, Dong Joon Kim3, Byung Moon Kim3, Seo Yeon Jung4, Woong Nam4, Kyung Won Kim1, Myung Hyun Sohn1, Kyu-Earn Kim1,5
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
3Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
4Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
5Department of Medicine, Sowha Children’s Hospital, Seoul, Korea
Correspondence  Kyung Won Kim ,Tel: 02-2228-2050, Fax: 02-393-9118, Email: kwkim@yuhs.ac,
Received: August 18, 2017; Revised: August 23, 2017   Accepted: October 10, 2017.  Published online: February 28, 2018.
ABSTRACT
Arteriovenous malformation (AVM) of the mandible is a rare vascular condition that can manifest as a wide range of symptoms and, on rare occasions, cause fatal hemorrhage. The symptoms of mandibular AVM can range from soft tissue swelling and tooth mobility to severe hemorrhage. The recognition of early symptoms is crucial for the prevention of a fatal hemorrhage and for the proper diagnosis and treatment of mandibular AVM. For emergency hemostasis of a ruptured mandibular AVM, manual compression with gauze, topical thrombin, absorbable hemostat, suturing the lesion, and replanting the extracted tooth is recommended. Multiple treatment options for mandibular AVM are available, such as arterial embolization, venous embolization, direct surgical closure, and bone resection. A combination of treatment options should be considered in complicated cases. We report a case of a 10-year-old girl with a previous history of telangiectasia on the right cheek presented with cardiac arrest resulting from massive bleeding immediately after a tooth extraction.
Key words: Arteriovenous Malformations, Mandible, Hemorrhage, Therapeutics
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