Question:

Which of the following is true?
1. Most pancreatic arteriovenous malformations are asymptomatic.
2. Gastrointestinal bleeding is common with pancreatic arteriovenous malformation.
3. Epigastric pain is highly specific for the diagnosis of pancreatic arteriovenous malformation.
4. Hereditary hemorrhagic telangiectasia is not associated with pancreatic arteriovenous malformation.
5. Pancreatic arteriovenous malformation is a frequently encountered incidental finding on computed tomography of the abdomen.





Answer:

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

2. Gastrointestinal bleeding is common with pancreatic arteriovenous malformation.



Explanation
1. Most pancreatic arteriovenous malformations present with gastrointestinal bleeding or abdominal pain. [Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but patients with these malformations may be asymptomatic.]

2. Gastrointestinal bleeding is common with pancreatic arteriovenous malformations.  [14/90 (16%) were asymptomatic. 48/90 (54%) presented with gastrointestinal bleeding, 29/90(32%) with abdominal pain or discomfort, and 4/90 (5%) with jaundice.]

3. Abdominal pain in pancreatic arteriovenous malformations is not localized to the epigastric region. [Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but patients with these malformations may be asymptomatic.]

4. Hereditary hemorrhagic telangiectasia is associated with pancreatic arteriovenous malformations.  [As many as 15% of patients with hereditary hemorrhagic telangiectasia (HHT) studied with CT have PAVMs, but the lesions have been small and incidental.]

5. Pancreatic arteriovenous malformation is rare.  [Pancreatic arteriovenous malformations are rare, with fewer than 100 reported cases.]



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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