Abstract
A 55-year-old man was referred to our hospital with hematemesis arld melena. Atemergency endoscopy, spurting ar flowing hemorrhage was noted in the second portion ofthe duodenum. Although the cause and site of hemorrhage was not clear, HS-E wasinfected topically to achieve primary hemostasis. The next day, the site of hemorrhage inthe duodenum was seen as a smooth reddened spot without ulceration. Avascularmalformation was suspected, and microwave coagulation using needle electorode wasper orme 44 watts, 15 sec×5 times. After two additional sessions of microwavecoagulation, the lesion disappeard and complete hemostasis was achieved. Abdominalangiography on the 14th hospital day showed racemose vascular network, which vvasvisualized in the region of the head of the pancreas and the duodenum as well as in the bodyand tail of the pancreas. The peripancreatic veins and portal vein were visualised in theearly arterial phase. Because the arteriovenous malfomation involved the whole pancreas, no surgical resection vas perfarrned. His stools have remained negative for occult bloodon follow up.
