Surgical outcomes of pancreatic arteriovenous malformation in a single center and review of literature

OBJECTIVE: Pancreatic arteriovenous malformation (P-AVM) is an extremely rare condition that can be accompanied by fatal complications. We have attempted to identify the possible management guidelines based on our and others' clinical experience. METHODS: We retrospectively analyzed our findings including clinical characteristics, imaging modalities, and treatment in 12 patients. Sporadic reports of 69 patients with P-AVM were surveyed for representative characteristics and treatment strategy. RESULTS: The mean age at diagnosis was 49.8 years (range, 44-64 years), and all 12 were male. The mean body mass index was 21.5 kg/m (range, 18.3-24.3 kg/m) and 6 (50%) were heavy smokers (mean, 30.9 pack-years; range, 7.5-120 pack-years). The most common clinical symptom is gastrointestinal bleeding, followed by abdominal pain. All patients were diagnosed with abdominal disease using computed tomography. Of the 12 patients, 11 underwent pancreatic resection and 1 patient was managed conservatively. No patient experienced any major postoperative complications during the median follow-up of 37 months. CONCLUSIONS: In patients with symptomatic P-AVM, surgical resection of the affected pancreas showed a successful result. When a patient is at a high risk for surgical treatment, transjugular intrahepatic portosystemic shunt, transarterial embolization, and radiation therapy might be other treatment options.