Aida Kayo, Nakamura Hayato, Kihara Yasuyuki, Abe Shintaro, Okamoto Koji, Otsuki Makoto
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan.
Eur J Gastroenterol Hepatol. 2002 May;14(5):551-4. doi: 10.1097/00042737-200205000-00013.
Arteriovenous malformation (AVM) of the pancreas is a rare condition that may cause severe gastrointestinal bleeding. We describe a 54-year-old man with a 7-year history of recurrent duodenal ulcer due to AVM in the pancreatic head. We recommended pancreatoduodenectomy because of recurrent haemorrhage from the duodenal ulcer, but the patient refused surgery on several occasions. He was admitted to our hospital complaining of severe upper abdominal pain radiating to the back and was diagnosed with acute pancreatitis. He agreed at that stage to the surgical treatment. The resected specimen contained a highly vascular malformation in the pancreatic head and ulceration in the adjacent descending duodenum. Histopathological examination revealed numerous vascular structures with dilated and tortuous vessels in the pancreatic head, confirming the presence of AVM. Moreover, oedema, inflammatory cell infiltration, haemorrhage and necrosis were evident, confirming the presence of acute pancreatitis.
胰腺动静脉畸形（AVM）是一种罕见疾病，可能导致严重的胃肠道出血。我们描述了一名54岁男性，因胰头AVM导致复发性十二指肠溃疡，病史长达7年。由于十二指肠溃疡反复出血，我们建议行胰十二指肠切除术，但患者多次拒绝手术。他因严重的上腹部疼痛放射至背部而入住我院，被诊断为急性胰腺炎。在那个阶段，他同意接受手术治疗。切除的标本显示胰头有高度血管化的畸形以及相邻降部十二指肠的溃疡。组织病理学检查显示胰头有许多血管结构，血管扩张且迂曲，证实存在AVM。此外，水肿、炎性细胞浸润、出血和坏死明显，证实存在急性胰腺炎。
