A Resected Case of Arteriovenous Malformation at the Pancreas Head

Shiho Sugimori, Yoshiyuki Nakajima, Hiromichi Kanehiro, Atsushi Yoshimura, Saiho Ko, Hiroshige Nakano, Hideo Uchida*

The First Department of Surgery and Radiology*, Nara Medical University

A case of arteriovenous malformation (AVM) of the pancreas head is described. A 36-year-o1d man was admitted to our hospital with complaints of tarry stool and severe epigastralgia. Laboratory studies revealed anemia only. Abdominal ultrasonography, CT scan, and MRI demonstrated a tumor in the pancrease head. The celiac trunk and superior mesenteric angiography revealed a hypervascular lesion in the pancreas head and early filling of the portal vein. The diagnosis of AVM was obtained. Doppler ultrasound was useful not only to diagnose the AVM, but also to determine the range of resection. Pylorus-preserving pancreaticoduodenectomy was performed. Histological examination of the resected specimen revealed abundant abnormal vessels including arteries and veins. AVM in the pancreatic region is a relatively rare condition. To our knowledge, only 40 cases have been reported in Japan. In many cases, gastrointestinal bleeding was present. Since AVM has multiple feeding arteries, transarterial embolization is not always effective, but surgical resection would be a radical treatment.

Key words
pancreas, arteriovenousmalformation, pylous preserving pancreaticoduodenectomy

Reprint requests
Shiho Sugimori First Department of Surgery, Nara Medical University
840 Shijo-cho, Kashihara, 634 JAPAN

Accepted
January 11, 1995

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