RESUMO
Arteriovenous malformation of the pancreas is a very rare entity. We describe a case involving the head of the pancreas associated with progressive hemobilia bleeding from the lower part of the common bile duct. The patient was a 50-year-old man with acute epigastralgia. Endoscopic retrograde cholangiopancreatography revealed hemobilia and cystic dilation of the common bile duct. Angiography demonstrated increased blood volume in the head of the pancreas and early filling of the superior mesenteric and portal veins. Abdominal pain and progressive anemia caused by hemobilia required surgical treatment. Histologic examination of the resected specimen revealed marked proliferation of the blood vessels in the pericholedochal area and the exact point of bleeding from the pancreaticobiliary arteriovenous malformation.
Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Cisto do Colédoco/diagnóstico por imagem , Ducto Colédoco/irrigação sanguínea , Hemobilia/diagnóstico por imagem , Pâncreas/irrigação sanguínea , Angiografia , Artérias/patologia , Malformações Arteriovenosas/patologia , Malformações Arteriovenosas/cirurgia , Colangiografia , Colangiopancreatografia Retrógrada Endoscópica , Cisto do Colédoco/patologia , Cisto do Colédoco/cirurgia , Hemobilia/patologia , Hemobilia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia , Poliarterite Nodosa/diagnóstico por imagem , Poliarterite Nodosa/patologia , Poliarterite Nodosa/cirurgia , Veias/patologiaAssuntos
Ascaríase/terapia , Doenças Biliares/terapia , Endoscopia do Sistema Digestório , Idoso , Feminino , HumanosRESUMO
A 65-year-old female with a history of cancer of the uterine body and a strong family history of cancer, was admitted with abdominal pain and anemia. During roentgenographic examination of the small intestine, a tumor was recognized about 25 cm from the ileocecal valve, leading us to suspect a carcinoma of the ileum. A colonoscopy demonstrated a constricting, ulcerated lesion, with a round wall: and a subsequent biopsy proved that the patient had a moderately differentiated adenocarcinoma. At surgery, a tumor, measuring 52 x 50 mm, was found to have infiltrated the serosa with a metastasis to the mesenteric lymph node.
