A Duodenal Arteriovenous Malformation Treated by Segmental Duodenal Resection after Selective Transcatheter Arterial Embolization

Abstract

Duodenal arteriovenous malformations (AVMs) are rare disorders associated with refractory ulcers and GI bleeding, and their treatment can be difficult. A case of a duodenal AVM in which the area of the feeding artery was identified and transcatheter arterial embolization (TAE) was done preoperatively, allowing a segmental duodenal resection to be safely performed, is reported.
A 45-year-old man was brought by ambulance with a chief complaint of hematemesis. Emergency endoscopy showed an ulcer with an exposed blood vessel in the third (horizontal) portion of the duodenum. Contrast CT and angiography showed a duodenal AVM. TAE of the feeding artery was done 2 days before surgery because of concern about massive bleeding from the AVM during surgery. Preoperative TAE to control intraoperative bleeding of a duodenal AVM has not been previously reported. Thus, this case is reported along with a discussion of the relevant literature.