Clinical Paper
Clinical Pathology
High-flow paediatric mandibular arteriovenous malformations: case reports and a review of current management

https://doi.org/10.1016/j.ijom.2017.06.011Get rights and content

Abstract

High-flow vascular malformations in the paediatric population are potentially life-threatening and are challenging to treat. This paper describes the management of three cases of mandibular arteriovenous malformations and reviews the contemporary management options for these serious lesions.

Section snippets

Case 1

An 11-year-old Polynesian male with neurofibromatosis type I, had a highly mobile left mandibular molar extracted at home by a family member. His local medical practitioner referred him to the emergency department (RCH) with prolonged haemorrhage 3 days later, due to an inability to control the bleeding with pressure packs.

On oral examination in the emergency department, torrential haemorrhage occurred spontaneously and haemoglobin was noted to be 63 g/l. The patient’s mouth was packed with gauze

Discussion

Paediatric intraosseous AVMs in the mandible are potentially life-threatening due to the risk of exsanguination and they are challenging to manage. The need to control profuse haemorrhage was the primary reason for referral to the hospital in each of these cases. However, patients may also present with headaches, toothaches, earaches, mobile teeth, gingival bleeding, facial asymmetry, and tissue expansion8. Intraosseous AVMs may also exist without symptoms, with lesions being detected

Patient consent

Written consent was obtained to publish the clinical photographs

Funding

None.

Ethical approval

Not required, as the patients in the case reports provided consent for use of the clinical material.

Competing interests

None.

Acknowledgements

The Department of Medical Imaging, Monash Medical Centre, Melbourne, and the Department of Medical Imaging, Royal Children’s Hospital Melbourne are acknowledged.

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