Pancreatic arteriovenous malformation with portal hypertension.
A 45-year-old man with recurrent episodes of hematemesis caused by extensive varices in the esophagus and stomach was admitted. He had a history of liver cirrhosis with hepatitis C virus infection. Computed tomography revealed a conglomeration of small strong nodular stains in the pancreatic head. Angiography revealed a racemose vascular network at the same site and early appearance of the portal venous system in the arterial phase. With a diagnosis of pancreatic arteriovenous malformation with portal hypertension, he underwent pylorus-preserving pancreaticoduodenectomy, preceded, 2 days earlier, by transcatheter arterial embolization of some of the feeding arteries. The varices observed preoperatively in the esophagus and stomach disappeared, and he has been well for 6 years after the operation. We reviewed 47 cases of pancreatic arteriovenous malformation previously reported in the English-language literature, with a focus on the clinical manifestations, treatment approaches, and etiological relationship with portal hypertension and liver cirrhosis.
Hosogi
Hisahiro
H
Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Shogoin, Kyoto 606-8507, Japan.
Ikai
Iwao
I
Hatano
Etsuro
E
Taura
Kojiro
K
Fujii
Hideaki
H
Yamamoto
Yuzo
Y
Shimahara
Yasuyuki
Y
D001165:Arteriovenous Malformations / Q000150:complications* / Q000601:surgery; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000601:surgery; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply* / Q000473:pathology; D010182:Pancreatic Diseases / Q000150:complications* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D012008:Recurrence; D014057:Tomography, X-Ray Computed