Muto Toshihiro, Shimizu Yasuhiro, Sano Tsuyoshi, Mizuno Nobumasa, Yamao Kenji, Nimura Yuji
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2008 May;105(5):719-24.
A 58-year-old man with a complaint of sever epigastralgia was referred to our hospital. At a previous hospital, he had been initially diagnosis as having ruputured aneurysm of the head of the pancreas. A final diagnosis of arteriovenous malformation of the head of the pancreas by MDCT and abdominal angiogram, and underwent pancreatoduodenectomy. Major feeding arteries were the gastroduodenal artery and inferior pancreatoduodenal artery, and the major drainage vein was the gastrocolic trunk. This case was also diagnosed as Osler-Weber-Rendu disease because of the presense of three of the four criteria for this disease: habitual epistaxis, oral telangiectasia, and angiodysplastic lesion in the internal organ. This is the first reported case of arteriovenous malformation with Osler-Weber-Rendu disease in Japan.
一名58岁主诉严重上腹痛的男性被转诊至我院。在之前的医院,他最初被诊断为胰头动脉瘤破裂。通过MDCT和腹部血管造影最终诊断为胰头动静脉畸形,并接受了胰十二指肠切除术。主要供血动脉为胃十二指肠动脉和胰十二指肠下动脉,主要引流静脉为胃结肠干。由于该疾病的四个标准中有三个存在,即习惯性鼻出血、口腔毛细血管扩张和内脏血管发育异常病变,该病例也被诊断为遗传性出血性毛细血管扩张症。这是日本首例报道的合并遗传性出血性毛细血管扩张症的动静脉畸形病例。