Abe Tsuyoshi, Suzuki Nobuyasu, Haga Junichirou, Azami Ayaka, Todate Yukitoshi, Waragai Mitsuru, Sato Atai, Takano Yoshinao, Kawakura Kenji, Imai Shigeki, Sakuma Hideo, Teranishi Yasushi
Department of Surgery, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Koriyama, 963-8563, Japan.
Department of Radiology, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Koriyama, 963-8563, Japan.
Surg Case Rep. 2016 Dec;2(1):6. doi: 10.1186/s40792-016-0133-x. Epub 2016 Feb 1.
Arteriovenous malformation (AVM) of the pancreas is uncommon in the gastrointestinal tract. We present a case of AVM of the pancreatic head in a 59-year-old male. He was admitted to a hospital with hematemesis and tarry stool and referred to our hospital in March 2014 on the diagnosis of pancreatic artery pseudoaneurysm. A computed tomography scan showed the presence of irregular dilated and/or stenotic vessels with meandering in the pancreatic head. Magnetic resonance imaging showed strong enhancement of the conglomeration in the pancreatic head. Selective angiography showed the proliferation of a vascular network in the pancreatic head and an early visualization of the portal vein at the arterial phase. The patient qualified for surgery with a preoperative diagnosis of AVM of the pancreatic head. We performed pylorus-preserving pancreaticoduodenectomy. The histological results confirmed the presence of irregular dilated tortuous arteries and veins in the pancreatic head. Surgical treatment may represent definitive management of symptomatic AVM.
胰腺动静脉畸形(AVM)在胃肠道中并不常见。我们报告一例59岁男性胰头AVM病例。他因呕血和柏油样便入院,于2014年3月被诊断为胰腺动脉假性动脉瘤后转诊至我院。计算机断层扫描显示胰头存在不规则扩张和/或狭窄的迂曲血管。磁共振成像显示胰头团块有强烈强化。选择性血管造影显示胰头血管网增生,动脉期门静脉早期显影。该患者术前诊断为胰头AVM,具备手术条件。我们实施了保留幽门的胰十二指肠切除术。组织学结果证实胰头存在不规则扩张、迂曲的动静脉。手术治疗可能是有症状AVM的确定性治疗方法。