Pancreatic Arteriovenous Malformations: A Case From Saudi Arabia.

Arteriovenous malformation (AVM) of the gastrointestinal tract is a rare anomaly, mostly due to congenital reasons. Patients with pancreatic AVM can live without experiencing symptoms. It can present with gastrointestinal bleeding or portal hypertension, and diagnosis can be made by computed tomography (CT) or angiography. CT findings include multiple discrete intrapancreatic vessels. A 48-year-old man complained of abdominal pain with a sensation of fullness that radiated to the back for a month, associated with shortness of breath, loss of appetite, and unintentional weight loss of 33% in one month without nausea or vomiting. On physical examination, the abdomen was soft and lax with epigastric tenderness and a negative Murphy sign. Laboratory investigations showed high amylase with normal liver and kidney functions. CT showed pancreatic AVM. He underwent partial pancreatectomy and splenectomy. After the surgery, the patient reported an improvement in symptoms. All follow-up visits were uneventful. Pancreatic AVM is a rare disease, and the most significant chief complaint of most patients is gastrointestinal tract bleeding. It requires imaging depending on the signs and symptoms. The primary imaging modality is CT, with subtraction angiography for confirmation. Surgical treatment is the standard of management for most patients when tolerable. Additionally, early detection of these rare anomalies can avoid massive gastrointestinal tract bleeding and the development of resistance portal hypertension and can save patients' lives if bleeding occurs.

Mucinous Cystic Neoplasm of the Pancreas in a Pregnant Woman: A Case Report and Review of the Literature.

Mucinous cystic neoplasms of the pancreas are rare tumors that represent 10% of cystic pancreatic tumors. They are potentially sex hormone-sensitive. However, mucinous cystic neoplasms occurring during pregnancy are relatively uncommon. A 33-year-old woman in her ninth week of gestation was referred to us due to abdominal pain for two months. Magnetic resonance imaging revealed a well-defined unilocular cystic lesion at the tail of the pancreas, measuring 7x6.4 cm. The patient underwent tumor resection with distal pancreatectomy and splenectomy during the second trimester to prevent the potential risk of rupture of the neoplasm, rapid growth, and/or intrauterine growth restriction. Histopathological examination revealed a mucinous cystadenoma with no atypia or malignancy. The patient completely recovered from the surgery and had a healthy full-term baby. This case shows the benefit of performing the surgery during the second trimester compared to the potential risk of delaying the surgery.