2019 Volume 39 Issue 6 Pages 1075-1078
A 70-year-old male had been repeatedly hospitalized for gastrointestinal bleeding from a refractory duodenal ulcer from 2 years previously. He had a history of chronic renal failure, thus a contrast CT scan had not been conducted. He was brought to our hospital with loss of consciousness (LOC) with high-degree anemia (Hb 4.5 g/dL), and endoscopic hemostasis was conducted against his hemorrhagic duodenal ulcer. This time contrast CT scan images were obtained after hospitalization, and a dilated hypervascular lesion was found in the pancreatic head, following which a pancreatic arteriovenous malformation (PAVM) was suspected. Many arteriovenous anomaly shunt vessels at the pancreatic head were found in the angiography test, thus this patient was diagnosed as having PAVMs. The recurring duodenal ulcer had been caused by the blood steal phenomenon associated with the PAVMs; therefore a subtotal stomach preserved pancreatoduodenectomy was undertaken, with a good postoperative course. As this case is a successful surgical excision of PAVMs, we report on our case with a review of the relevant literature.
