Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 10 F 201 Section 2 Shipai Road, Taipei, 112, Taiwan.
J Gastrointest Surg. 2013 Jul;17(7):1240-6. doi: 10.1007/s11605-013-2217-2. Epub 2013 May 2.
Pancreatic arteriovenous malformation is very rare, but may cause significant clinical symptoms such as catastrophic bleeding. Herein, we discuss the clinical presentation and management of patients pancreatic arteriovenous malformations.
The data pool for the analysis was collected from pancreatic arteriovenous malformation cases encountered by our institution and sporadic case reports in the English literature.
A total of 89 cases of pancreatic arteriovenous malformation were collected for this study, including 59 cases of arteriovenous malformation in the pancreatic head (62.3 %) and 30 in the pancreatic body-tail (33.7 %). The most commonly associated complications for overall cases of pancreatic arteriovenous malformation were bleeding (50.6 %), pancreatitis (16.9 %), portal hypertension (6.7 %), and pseudocyst (3.4 %). The most common presenting symptom of pancreatic arteriovenous malformation was gastrointestinal bleeding (47.2 %), followed by epigastric pain (46.1 %). Surgery (43.8 %) was the most common treatment for pancreatic arteriovenous malformation cases, followed by transarterial embolization (11.2 %), a combination of surgery and transarterial embolization (10.1 %), and radiotherapy (2.2 %). No intervention was done for 29.2 % of the cases of pancreatic arteriovenous malformation.
Pancreatic arteriovenous malformation occurs most commonly in the pancreatic head; gastrointestinal bleeding is the main symptom. Surgical resection or transarterial embolization appears to be indicated in patients with symptomatic pancreatic arteriovenous malformation.
胰腺动静脉畸形非常罕见，但可能引起显著的临床症状，如灾难性出血。在此，我们讨论胰腺动静脉畸形患者的临床表现和处理方法。
本分析的数据来源于我们机构遇到的胰腺动静脉畸形病例和英文文献中的散发病例报告。
本研究共收集了 89 例胰腺动静脉畸形病例，其中胰头部动静脉畸形 59 例（62.3%），胰体尾部 30 例（33.7%）。胰腺动静脉畸形的常见并发症包括出血（50.6%）、胰腺炎（16.9%）、门静脉高压（6.7%）和假性囊肿（3.4%）。胰腺动静脉畸形的最常见表现症状为胃肠道出血（47.2%），其次为上腹痛（46.1%）。手术（43.8%）是胰腺动静脉畸形最常见的治疗方法，其次是经动脉栓塞术（11.2%）、手术联合经动脉栓塞术（10.1%）和放疗（2.2%）。29.2%的胰腺动静脉畸形病例未进行干预。
胰腺动静脉畸形最常发生于胰头部；胃肠道出血是主要症状。对于有症状的胰腺动静脉畸形患者，手术切除或经动脉栓塞术似乎是合理的选择。
