Question:

Which of the following is false?
1. Radiofrequency ablation is commonly utilized to treat pancreatic arteriovenous malformation.
2. Transjugular intrahepatic portosystemic shunting may be indicated in patients with portal hypertension or variceal bleeding.
3. Surgical resection may be required in select cases.
4. Pancreatic arteriovenous malformation may be complicated by pancreatitis.
5. Pancreatic arteriovenous malformation is best imaged in the arterial phase of contrast enhanced computed tomography imaging.





Answer:

The correct answer for the question "Which of the following is false?" is:

1. Radiofrequency ablation is commonly utilized to treat pancreatic arteriovenous malformation.



Explanation
1. Radiofrequency ablation is not a recognized treatment of pancreatic arteriovenous malformation.  [Treatment of symptomatic patients, including patients with varices and gastrointestinal bleeding has included arterial embolization, transjugular intrahepatic portosystemic shunting (TIPS), vascular ligation and pancreatic resection.]

2. Transjugular intrahepatic portosystemic shunting has been utilized to treat patients with late complications of pancreatic arteriovenous malformation.  [Treatment of symptomatic patients, including patients with varices and gastrointestinal bleeding has included arterial embolization, transjugular intrahepatic portosystemic shunting (TIPS), vascular ligation and pancreatic resection.]

3. Surgery may be indicated.  [A literature review reported that 22/90 (24%) patients were treated conservatively while 60/90 (67%) had interventions, most often pancreatic resection 35/90 (39%) and arterial embolization 15/90 (17%).]

4. Pancreatic arteriovenous malformation may be complicated by pancreatitis.  [In a 2006 literature review of 51 patients, 6/51 (12%) presented with pancreatitis.]

5. Pancreatic arteriovenous malformation is best visualized on arterial phase imaging.  [CT findings include multiple discrete intrapancreatic vessels, best demonstrated on early arterial scanning and associated with early portal vein opacification.]



From the manuscript:
Pancreatic Arteriovenous Malformation: a case report and literature review
Radiology Case. 2011 Aug; 5(8):8-13


This article belongs to the GI section.




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From the manuscript

Pancreatic Arteriovenous Malformation: a case report and literature review

Free full text article: Pancreatic Arteriovenous Malformation: a case report and literature review

Abstract
Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but these patients may be asymptomatic. Increased portal vein flow from these malformations can lead to portal hypertension and gastrointestinal bleeding. Diagnosis is often made by imaging, and early diagnosis has led to successful surgical resection or percutaneous embolization. We report a patient with PAVM, diagnosed by CT and angiography, who has remained asymptomatic for 2 years without treatment.






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