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Rare Cause of Gastrointestinal Bleeding: A Case Report of Pancreatic Arteriovenous Malformation.

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  • معلومة اضافية
    • المصدر:
      Publisher: International Scientific Information, Inc Country of Publication: United States NLM ID: 101489566 Publication Model: Electronic Cited Medium: Internet ISSN: 1941-5923 (Electronic) Linking ISSN: 19415923 NLM ISO Abbreviation: Am J Case Rep Subsets: MEDLINE
    • بيانات النشر:
      Publication: <2014- > : Smithtown, NY : International Scientific Information, Inc.
      Original Publication: Albertson, NY : International Scientific Literature, Inc.
    • الموضوع:
      Arteriovenous Malformations*/complications ; Arteriovenous Malformations*/diagnostic imaging ; Chronic Pain* ; Duodenal Ulcer*/complications; Adult ; Humans ; Male ; Duodenum ; Gastrointestinal Hemorrhage/etiology ; Pancreas ; Pancreaticoduodenectomy
    • نبذة مختصرة :
      BACKGROUND Arteriovenous malformation is an unusual cause of gastrointestinal bleeding, particularly in the pancreas. A definitive treatment strategy is not yet established. CASE REPORT We present the case of a 37-year-old man with underlying hypertension and no significant family history who presented with a 3-month history of intermittent epigastric pains and unintentional weight loss of 5 kg in 2 months. The upper endoscopy showed a large duodenal ulcer, which was uncontrolled with a standard dose of proton pump inhibitors. An abdominal computed tomography scan with contrast was indicated and revealed an enhanced mass of 2.5×3.5×4 cm in size, located on the second and third parts of the duodenum and head of the pancreas, indicating an arteriovenous malformation. On day 10 of hospitalization, the patient suddenly had melena and a drop of hemoglobin level to 5.6 g/dL; angiography intervention was successful to control the bleeding. However, gastrointestinal bleeding recurred after 2 weeks, and the patient successfully underwent a Whipple procedure. CONCLUSIONS The diagnosis and therapeutic management of arteriovenous malformations are uniquely challenging; therefore, pancreatic arteriovenous malformations should be listed on the differential diagnosis, particularly in those cases with non-healing and large duodenal ulcers. Otherwise, early imaging modalities should be performed to confirm the diagnosis. In particular, angiography can temporarily control bleeding before proceeding with more definitive therapy.
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    • الموضوع:
      Date Created: 20231123 Date Completed: 20240216 Latest Revision: 20240216
    • الموضوع:
      20240217
    • الرقم المعرف:
      PMC10684828
    • الرقم المعرف:
      10.12659/AJCR.941638
    • الرقم المعرف:
      37995202