Arteriovenous malformation of the pancreatic head – difficulties in diagnosis and treatment.

A patient with pancreatic arteriovenous malformation who presented diagnostic and therapeutic difficulties is presented. The initial tests appeared to suggest inflammatory bowel disease, but the diagnosis was clinched by the finding of blood issuing from the ampulla of Vater. Repeated angiographic embolization did not obliterate the vascular malformation, and the symptoms eventually resolved after Whipple’s pancreaticoduodenectomy.

Endoscopic removal of chicken bone that caused gastric perforation and liver abscess.

A 40-yr-old gentleman presented with abdominal pain, nausea and vomiting since 3 weeks. CT scan of the abdomen showed a liver abscess but also a bone penetrating the left lobe of the liver. A 5-cm-long chicken bone was removed endoscopically. He was discharged on day 8 and was asymptomatic 12 months later. Endoscopic retrieval of an extraluminal foreign body causing liver abscess has not been reported previously.