Hakoda Hiroyuki, Kawaguchi Yoshikuni, Miyata Yoichi, Togashi Junichi, Nagai Motoki, Suzuki Yoshio, Nomura Yukihiro
Department of Surgery, Asahi General Hospital, Chiba, Japan.
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Surg Case Rep. 2022 Sep 28;2022(9):rjac427. doi: 10.1093/jscr/rjac427. eCollection 2022 Sep.
Arteriovenous malformations (AVMs) are uncommon in the gastrointestinal tract, particularly in the pancreas. AVMs cause complications, including gastrointestinal bleeding, portal hypertension and pancreatitis. Therefore, a treatment strategy is not yet established. Surgical treatment or transcatheter arterial embolization is performed in patients with AVM, considering their conditions. A 54-year-old man presented with acute abdominal pain was diagnosed with acute pancreatitis due to AVM of the pancreatic head using dynamic computed tomography. Endoscopic ultrasonography further revealed meandering blood vessels in the pancreatic head. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy. Histological examination revealed AVM of the pancreatic head with chronic pancreatitis. The patient had a good postoperative clinical course and was discharged on postoperative day 22. He remained asymptomatic. Pancreaticoduodenectomy can be considered an effective treatment method for selected cases of symptomatic AVM of the pancreatic head.
动静脉畸形（AVM）在胃肠道中并不常见，尤其是在胰腺。AVM会引发包括胃肠道出血、门静脉高压和胰腺炎在内的并发症。因此，尚未确立治疗策略。对于患有AVM的患者，会根据其病情进行手术治疗或经导管动脉栓塞术。一名54岁男性因急性腹痛就诊，经动态计算机断层扫描诊断为胰头AVM所致的急性胰腺炎。内镜超声检查进一步显示胰头有迂曲血管。该患者接受了保留胃的胰十二指肠次全切除术。组织学检查显示胰头AVM合并慢性胰腺炎。患者术后临床过程良好，术后第22天出院。他一直无症状。对于选定的有症状的胰头AVM病例，胰十二指肠切除术可被视为一种有效的治疗方法。
