Acquired arteriovenous fistulas in children

Five boys with acquired arteriovenous fistulas are presented; four had factor VIII deficiencies, and one had a hepatic-induced coagulopathy. The cause of the fistula was the trauma induced by single or repeated venous and/or arterial punctures. All five developed a slowly progressive pulsatile mass of over a period of months. Patients with coagulopathies all developed complications with repeated inadvertent puncture of these masses. Clinical examination and magnetic resonance imaging scans clearly highlight this problem. Surgical ligation is recommended for progressive enlargement.