A Case of Arteriovenous Malformation of the Pancreatic Body and Tail

Namika Fujikawa, Katsuhiko Inoue, Keiichirou Kanemitsu, Tatsuya Tsuji, Takehisa Hiraoka and Michio Kawasuji

First Department of Surgery, Kumamoto University School of Medicine

The arteriovenous malformation of the pancreas we report is very rare. A 53-year-old man with sudden severe hypochondralgia was found in enhanced computed tomography scan showed to have a high-density area in the tail of the pancreas. Magnetic resonance imaging T1 weighted imaging showd a signal-void sign at the same area. Four arteriovenous shunts were detected in the body and tail of the pancreas of SMA, IMA, splenic artery and left gastric artery by angiography. We diagnosed arteriovenous malformation of the pancreas, and conducted distal pancreatectomy. During surgery, we confirmed decreased portal blood pressure and portal blood O₂ partial pressure before and after pancreatic resection. Surgical resection of the pancreas should be done to prevent portal hypertension by pancreatic AVM. Pancreatic resection has an extremely low recurrence of pancreatic AVM compared to transarterial embolization or surgical ligation of the feeding artery.

Key words
pancreatic arteriovenous malformation, portal hypertension

Reprint requests
Namika Fujikawa First Department of Surgery, Kumamoto University school of Medicine 1-1-1 Honjyo, Kumamoto city, 860-8556 JAPAN

Accepted
July 24, 2002

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