Successful treatment of intractable duodenal ulcer due to pancreatic arteriovenous malformation with transcatheter arterial embolization

Abstract

A 66 year-old man with palpitation was referred to our hospital for the evaluation. We diagnosed a duodenal ulcerous lesion as the cause of his anemia through esophagogastroduodenoscopy. However, administration of one-month potassium-competitive acid blocker was not fully effective. The healing of ulcer lesion delayed and little regenerating epithelium was observed. Anemia and gastrointestinal bleeding recurred repeatedly. Then, we performed angiography and found that abnormal network of blood vessels in uncinate process of the pancreas and early visualization of portal vein. We diagnosed pancreatic arteriovenous malformation (PAVM) as the cause of his ulcerous lesion in this case. We performed transcatheter arterial embolization. Fortunately, anemia and gastrointestinal bleeding have not recurred for 6 months.