Distal pancreatectomy for pancreatic arteriovenous malformation: report of a case

Abstract

Arteriovenous malformation (AVM) of the pancreas is an uncommon disease, which can cause an abdominal pain. This disease is characterized by a tangled vascular network, including the whole or part of the pancreas, resulting in portal hypertension by forming a shunt of the pancreas arteries to drain directly into the portal venous system. This study presents a case that was suspected as AVM of the pancreas by preoperative contrast-enhanced computed tomography scan (CT). A 49-year-old male patient had several episodes of abdominal discomfort associated with dyspepsia for 4 days. Magnetic resonance imaging showed enhancement of the conglomeration about 1.5 cm size in diameter in the pancreas. Selective angiography showed the proliferation of a vascular network in the pancreas and an early visualization of the portal vein during the arterial phase. Distal pancreatectomy with splenectomy was done. Histology of the pancreas showed AVM, with enzymatic fat necrosis extending to the capsule of the pancreas. The patient recovered successfully without postoperative complications. Surgical resection of pancreas is the definitive treatment for symptomatic AVM.