A Case of Pancreatic Arteriovenous Malformation Associated With Duodenal Ulcer

Abstract

Pancreatic arteriovenous malformation is a very rare disease. We report a case of pancreatic arteriovenous malformation associated with duodenal ulcer on the bulbus of the duodenum causing massive intestinal bleeding. A 66-year-old male was admitted to our hospital complaining of epigastralgia and tarry stool. Endoscopic examination revealed duodenal ulcer with continuous bleeding and endoscopic clipping was performed. Abdominal ultrasonographic examination revealed a hypoechoic mass in the head of the pancreas. Color Doppler abdominal ultrasonographic examination revealed a mosaic-like color signal in the hypoechoic mass. Abdominal angiography showed racemose vascular network in the head of the pancreas. Because epigastric discomfort and tarry stool were increased, emergency pylorus preserving pancreatoduodenectomy was performed. Histologically, there were numerous vascular structures with dilated and tortuous vessels at the pancreas head, and the adjacent duodenal wall was destroyed by pancreatic arteriovenous malformation.