Onishi Yasuyuki, Kimura Hiroyuki, Shimizu Marina, Oka Shojiro, Umeda Makoto, Kimura Toshiyuki, Kanagaki Mitsunori
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
Radiol Case Rep. 2021 Apr 30;16(7):1708-1711. doi: 10.1016/j.radcr.2021.04.035. eCollection 2021 Jul.
A 62-year-old man with liver cirrhosis presented with deterioration of liver function. Imaging studies revealed an arteriovenous malformation (AVM), with a dilated venous space, at the pancreatic head. Transarterial embolization of the AVM, using microcoils, was performed, although many feeding arteries remained. As the transarterial embolization was incomplete, further liver function deterioration was a possibility. In fact, 1 year after the procedure, the patient was referred back to our hospital for treatment of massive ascites and liver function deterioration. Transportal embolization of the dilated venous space was performed, using microcoils via the recanalized paraumbilical vein, with no enhancement of the AVM. No complications occurred. Based on our experience, we propose transportal embolization as an effective treatment option for pancreatic AVM.
一名62岁的肝硬化男性患者出现肝功能恶化。影像学检查显示胰头部存在动静脉畸形(AVM),伴有扩张的静脉腔隙。尽管仍有许多供血动脉,但使用微线圈对AVM进行了经动脉栓塞。由于经动脉栓塞不完全,肝功能可能会进一步恶化。事实上,术后1年,该患者因大量腹水和肝功能恶化被转回我院治疗。通过再通的脐旁静脉使用微线圈对扩张的静脉腔隙进行门静脉栓塞,AVM未强化。未发生并发症。根据我们的经验,我们建议将门静脉栓塞作为胰腺AVM的一种有效治疗选择。