Department of Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, South Korea.
Pancreas. 2012 Apr;41(3):388-96. doi: 10.1097/MPA.0b013e31822a25cc.
Pancreatic arteriovenous malformation (P-AVM) is an extremely rare condition that can be accompanied by fatal complications. We have attempted to identify the possible management guidelines based on our and others' clinical experience.
We retrospectively analyzed our findings including clinical characteristics, imaging modalities, and treatment in 12 patients. Sporadic reports of 69 patients with P-AVM were surveyed for representative characteristics and treatment strategy.
The mean age at diagnosis was 49.8 years (range, 44-64 years), and all 12 were male. The mean body mass index was 21.5 kg/m (range, 18.3-24.3 kg/m) and 6 (50%) were heavy smokers (mean, 30.9 pack-years; range, 7.5-120 pack-years). The most common clinical symptom is gastrointestinal bleeding, followed by abdominal pain. All patients were diagnosed with abdominal disease using computed tomography. Of the 12 patients, 11 underwent pancreatic resection and 1 patient was managed conservatively. No patient experienced any major postoperative complications during the median follow-up of 37 months.
In patients with symptomatic P-AVM, surgical resection of the affected pancreas showed a successful result. When a patient is at a high risk for surgical treatment, transjugular intrahepatic portosystemic shunt, transarterial embolization, and radiation therapy might be other treatment options.
胰腺动静脉畸形（P-AVM）是一种极为罕见的疾病，可伴有致命并发症。我们试图根据我们和他人的临床经验确定可能的治疗指南。
我们回顾性分析了 12 例患者的临床特征、影像学检查和治疗结果。同时，还对 69 例 P-AVM 患者的散发病例报告进行了调查，以了解其代表性特征和治疗策略。
诊断时的平均年龄为 49.8 岁（范围为 44-64 岁），12 例均为男性。平均体重指数为 21.5kg/m²（范围为 18.3-24.3kg/m²），6 例（50%）为重度吸烟者（平均吸烟量为 30.9 包/年；范围为 7.5-120 包/年）。最常见的临床症状是胃肠道出血，其次是腹痛。所有患者均通过计算机断层扫描诊断为腹部疾病。在 12 例患者中，11 例行胰腺切除术，1 例患者保守治疗。在中位数为 37 个月的随访期间，没有患者出现任何重大术后并发症。
对于有症状的 P-AVM 患者，胰腺受累部位的手术切除显示出良好的治疗效果。当患者存在手术治疗高风险时，经颈静脉肝内门体分流术、经动脉栓塞术和放射治疗可能是其他治疗选择。
