Pancreatic Arteriovenous Malformation

Abstract

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.

Multimodality Imaging of Pancreatic Arteriovenous Malformation

“…1,3 In a survey by Meyer et al 9 of symptomatic arteriovenous malformations (AVMs) of the GI system, only 2 of 218 (0.9%) were pancreatic. PAVMs are most commonly located in the head of the pancreas, followed by the body or tail.…”

“…All or part of the pancreas may be involved. 1,2 PAVMs are quite rare, with fewer than 100 case reports in the English-language literature. 1,3 Symptomatic and asymptomatic patients have been reported.…”

“…When symptoms are present, the most common presenting symptoms are gastrointestinal (GI) bleeding and abdominal pain. 1,2,4 PAVM may be demonstrated with several modalities, including contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI) with or without contrast, angiography, transabdominal ultrasound (US), endoscopic US, endoscopic retrograde cholangiopancreatography (ERCP), and scintigraphy. On CT, PAVM is characterized by arterial-phase enhancement of multiple feeding arteries with early filling of draining veins, including the splenic and portal vein.…”

A Successful Case of Transcatheter Arterial Embolization with N-butyl-2-cyanoacrylate for Pancreatic Arteriovenous Malformation

“…With respect to the management of pancreatic AVM, surgical therapy and conservative modalities, such as TAE, irradiation, transjugular intrahepatic portosystemic shunt (TIPS) or treatment of esophageal varices, have been applied (1,3,8). Although surgical resection is the most common treatment modality and usually achieves a complete cure, it is not always feasible due to difficulties during surgery based on limitations regarding the size, location and accessibility of the AVM and/or the risk of massive hemorrhage (15).…”

“…Most patients present with complications such as abdominal pain, signs of acute pancreatitis, gastrointestinal bleeding and portal hypertension (1,2). Surgical resection is considered to be a radical treatment for pancreatic AVM; however, transcatheter arterial embolization (TAE) has been performed as an alternative approach in recent years (3)(4)(5).…”