Surgical Management of Pancreatic Head Arteriovenous Malformation: A Case Report

TL;DR

A rare case of pancreatic arteriovenous malformation was surgically treated due to diagnostic uncertainty and biliary obstruction.

Contribution

This case report adds to the limited literature on pancreatic arteriovenous malformations and advocates for surgical resection in ambiguous cases.

Findings

A 48-year-old female was diagnosed with a pancreatic arteriovenous malformation after surgical exploration.

Histopathology confirmed abnormal vascular channels and organized hematoma.

Surgical resection is recommended when malignancy or obstruction cannot be ruled out.

Abstract

Pancreatic arteriovenous malformations (PAVMs) are uncommon abnormalities of pancreatic blood vessels that result in direct, high-flow connections between arteries and veins. There are currently fewer than 200 reported cases in the literature of this particular anomaly. They are often clinically asymptomatic but may present with abdominal pain, gastrointestinal bleeding, or features of portal hypertension, and can resemble cystic or neoplastic lesions on imaging. We report a case of a 48-year-old female with a pancreatic head mass presenting with non-specific abdominal pain and jaundice. Owing to diagnostic uncertainty and biliary obstruction, an open, stomach-preserving pancreaticoduodenectomy was performed. Intraoperatively, a tense blood-filled cyst was identified; histopathology demonstrated an organised haematoma with abnormal vascular channels consistent with a pancreatic arteriovenous malformation. This case highlights the diagnostic challenge posed by pancreatic arteriovenous malformations and supports surgical resection as definitive management when malignancy or obstruction cannot be confidently excluded.

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