Transcatheter embolization of pancreatic arteriovenous malformation associated with recurrent acute pancreatitis

Abstract

Pancreatic arteriovenous malformation (PAVM) is extremely rare; even rarer is its association with pancreatitis. The authors report a case of PAVM causing recurrent episodes of acute pancreatitis in a 46-year-old male. Patient refused surgery and was treated with transcatheter arterial embolization using liquid embolic agent (mixture of n-butyl-2-cyanoacrylate glue and lipiodol), which resulted in a significant decrease in the size of the PAVM.

Resection of a pancreatic capillary lymphatic malformation through a partial pancreatectomy: a case report

“…PD is mostly performed for pancreatic vascular malformations [7]. Transcatheter arterial embolization is also considered as a treatment for this condition [8]; however, it can be performed only for arterial dominant tumor (not in this case), and its success rate varies between reports [9]. If there is an indication, surgical resection is considered to be the best approach for complete curative management of pancreatic vascular malformation, though it carries the risk of massive intraoperative bleeding.…”

Intrapancereatic abscess due to arteriovenous malformation involving the entire pancreas: A case report and review of the literature

“…Pancreatic arteriovenous malformation (P-AVM) first reported in 1986 by Halpern et al, and defined as a vascular anomaly in which blood flows from the arterial system directly into the portal venous system without passing through the capillaries in the pancreas [ 2 ]. It is a very rare anomaly with less than 1% incidence of all gastrointestinal vascular anomalies.…”

“…By reviewing the literature in the English language, no more than 130 reported case of P-AVM including cases described secondary in articles with a different main title. There are two articles reporting four cases of P-AVM which involving the entire pancreas; First three cases reported by Ki Byung Song et al, in a study of sixty nine patients from 1999 to 2010 [ 2 ]. The fourth case reported by Shimizu K et al, in 2013 [ 5 ].…”

“…Therefore, treatment of an asymptomatic P-AVM patient is recommended as early prevention of portal hypertension. Portal hypertension once developed cannot be treated even with surgical resection [ 2 ].…”

“…Pancreatic arteriovenous malformation (P-AVM) is an extremely rare entity, even more rare to involve whole parts of the pancreas [ 1 ]. Although the diagnosis of P-AVM is easy after imaging modalities development, it can be missed in asymptomatic patient and lead to fatal complications [ 2 ]. There are several articles report a successful treatment with transcatheter arterial embolization (TAE), and radiotherapy, but surgical resection appears to be the only curative treatment [ 3 ].…”