Third Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Second Department of Surgery, University of Toyama, Toyama, Japan.
Clin J Gastroenterol. 2021 Feb;14(1):364-369. doi: 10.1007/s12328-020-01231-3. Epub 2020 Sep 21.
Arteriovenous malformation (AVM) in the pancreas rarely causes acute pancreatitis. However, even when it does cause pancreatitis, the pathogenesis is unclear. A 61-year-old man was admitted to our hospital for acute pancreatitis. The findings of computed abdominal tomography, magnetic resonance imaging, and endoscopic ultrasonography revealed pancreatic AVM and hematoma in the tail of the pancreas. These lesions were suspected to be associated with pancreatitis. Although endoscopic retrograde pancreatography could not confirm hemosuccus pancreaticus, distal pancreatectomy was performed because of repeated pancreatitis. The histopathological findings of the resected specimen revealed rupture of the AVM vessels into the main pancreatic ducts. Finally, we considered that intermittent bleeding due to AVM rupture and hematoma formation in the main pancreatic duct caused the repeated pancreatitis.
胰腺动静脉畸形(AVM)很少引起急性胰腺炎。然而,即使它确实引起胰腺炎,其发病机制也不清楚。一名 61 岁男性因急性胰腺炎入院。腹部计算机断层扫描、磁共振成像和内镜超声检查的结果显示胰腺 AVM 和胰腺尾部血肿。这些病变疑似与胰腺炎有关。尽管内镜逆行胰胆管造影术不能证实胰管出血,但由于反复发作的胰腺炎,进行了远端胰腺切除术。切除标本的组织病理学检查结果显示 AVM 血管破裂进入主胰管。最后,我们认为 AVM 破裂导致主胰管间歇性出血和血肿形成是反复发生胰腺炎的原因。