Arteriovenous Malformations of the Bowel

Meyer, Christopher T.; Troncale, Frank J.; Galloway, Shelby J.; Sheahan, Daniel G.

doi:10.1097/00005792-198101000-00004

Cited by 185 publications

(18 citation statements)

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“…The optimal diagnosis and treatment strategy for multiple AVMs of the small bowel have not been fully elucidated. It has been reported that 5–37% of patients who underwent resection of AVMs will rebleed and one of the causes is incomplete excision [10, 14, 15]. The series of methods and techniques that we report here will contribute to the clinical treatment of AVMs of the small bowel.…”

Section: Discussionmentioning

confidence: 88%

Management of Multiple Arteriovenous Malformations of the Small Bowel

Hirakawa

Ishizuka

Sato

et al. 2019

Case Reports in Medicine

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A 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the patient had recurrent intermittent bloody stools with a significant decrease in hemoglobin levels. Although no active bleeding was observed on antegrade DBE, we detected a pulsatile submucosal uplift accompanied by a small red patch on the top of the uplift in the jejunum. Arteriovenous malformation (AVM) was suspected as the cause of small-bowel bleeding. Multiple-phase CT showed a number of small vascular ectasias during the arterial phase in the jejunum, and we confirmed the presence of multiple AVMs in the jejunum by selective angiography. To identify the location of the lesions and determine the minimal surgical margins, we performed intraoperative selective angiography with indocyanine green (ICG) injection. This technique allowed us to clearly observe the region and perform segmental small-bowel resection with minimal surgical margin. The patient reported that she has had no gastrointestinal bleeding at the two years follow-up visit.

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Section: Discussionmentioning

confidence: 88%

Management of Multiple Arteriovenous Malformations of the Small Bowel

Hirakawa

Ishizuka

Sato

et al. 2019

Case Reports in Medicine

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“…The incidence of pancreatic vascular malformation is extremely low. In previous reports, the common sites of AVM in the digestive organs are as follows: cecum and ascending colon (78%), jejunum (10.5%), ileum (5.5%), duodenum (2.3%), stomach (1.4%), and pancreas (0.9%) [3]. Most patients with pancreatic vascular malformation are diagnosed because they experience abdominal pain, gastrointestinal bleeding, and pancreatitis; however, 22% of the patients are asymptomatic [5] and are only diagnosed by chance.…”

Section: Discussionmentioning

confidence: 99%

“…Though it is a benign disease, it is clinically important because it can cause epigastric pain, pancreatitis, portal vein hypertension, bleeding, and rupture [2]. However, pancreatic vascular malformation is a rare disease [3] despite the advancement of various imaging modalities [4]. Moreover, most of the pancreatic vascular malformations are arteriovenous malformations (AVMs), with the other types of malformations being rare.…”

Section: Introductionmentioning

confidence: 99%

Resection of a pancreatic capillary lymphatic malformation through a partial pancreatectomy: a case report

et al. 2019

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Background Pancreatic vascular malformation causes epigastric pain, pancreatitis, portal vein hypertension, bleeding, and rupture. It is a rare disease, with most pancreatic vascular malformations being arteriovenous malformations (AVMs) and the other types of malformations being rare. We report a case of capillary lymphatic malformation (CLM) in the pancreatic uncinate process. Case presentation A 74-year-old woman, who presented with complaints of repeated upper abdominal pain, was admitted to our institution. Contrast-enhanced dynamic computed tomography (CT) scan revealed that the tumor in the pancreatic uncinate process had a poor contrast effect in the arterial phase and a small contrast effect in the equilibrium phase, which are suggestive of a benign disease-like vascular malformation. However, we suspected that it could possibly be a malignant tumor because the tumor size tended to increase over time; thus, we decided to perform a surgery. We resected the tumor through a partial resection of the pancreas. Macroscopically, the cut surface of the tumor had a spongioid appearance. Histopathological examination findings showed a mixed shape of small capillaries and lymphatic ducts. The patient was diagnosed with CLM according to the International Society for the Study of Vascular Anomalies (ISSVA) classification, based on the histological appearance and immunostaining findings. The postoperative course of the patient was uneventful. Conclusions We reported a case of pancreatic vascular malformation, specifically a CLM, which was completely resected through a partial pancreatectomy.

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“…32 Angiodysplasia and diverticula are the most VOLUME 2, NUMBER 4, JULy/AuGUST 1982 common causes of massive bleeding from the large bowel; in one series 20% of patients had the former and 43% had the latterY Most diverticula that bleed massively are located in the right colon;32 angiodysplasias also are diagnosed most commonly by arteriography of the superior mesenteric artery. 33,34 If the bleeding is very slow or has stopped, a barium enema by air contrast technique, if possible, should be done next. Polyps, malignant lesions, or evidence of inflammatory bowel disease may be revealed as the likely cause of bleeding by a barium study.…”

Section: Lower Gastrointestinal Bleedingmentioning

confidence: 99%

Evaluation and Medical Therapy of Acute Gastrointestinal Bleeding

Spiro

Peppercorn

1982

Pharmacotherapy

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Gastrointestinal bleeding is a major reason for hospitalization and an important cause of morbidity and mortality. Diagnosis and treatment of this common clinical problem has changed markedly over the past 40 years. The initial approach to patients with gastrointestinal bleeding should be both therapeutic and diagnostic, with close attention to cardiovascular status and clotting parameters. Once the patient is stabilized, clinical history, physical examination, gastric aspirate, and laboratory data should be assessed to determine if the bleeding site is in the upper or lower gastrointestinal tract. Once that is determined, a more specific diagnosis should be made if possible, as therapy often will depend upon a precise diagnosis. Therapy includes angiographic and pharmacologic techniques, as well as tamponade in the case of esophageal varices. The use of antacids in acute upper gastrointestinal bleeding is well established, while the role of cimetidine is less clear. Newer modalities of treatment, such as the use of laser coagulation, are currently being evaluated.

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Arteriovenous Malformations of the Bowel

Cited by 185 publications

References 0 publications

Management of Multiple Arteriovenous Malformations of the Small Bowel

Management of Multiple Arteriovenous Malformations of the Small Bowel

Resection of a pancreatic capillary lymphatic malformation through a partial pancreatectomy: a case report

Evaluation and Medical Therapy of Acute Gastrointestinal Bleeding

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