J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 4373KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 86(8): 953-958, 1985

Original article

PORTOSYSTEMIC A-V FISTULA AND PORTAL HYPERTENTION ASSOCIATED WITH ISLET-CELL TUMOR OF THE PANCREAS

Department of Surgery, The Research Institute for Chest Diseases and Cancer, Tohoku University,, Sendai, Japan
*) Tohoku Central Hospital of the Mutual Aid Association of Public School Teachers, Yamagata, Japan

Masashi Handa, Tasuku Nakada, Satoru Kajitsuka*), Masanori Hirose*), Yukihiro Sato*)

A 50-year-old woman was admitted on Feb. 25, 1983, complaining of hematemesis and melena. Endoscopic examination revealed the rupture of the esophageal varices. At first she was treated with pressure hemostasis using a S-B tube, but it was failed. Then she underwent esophageal transection under emergency thoracotomy. After the operation, she developed ascites and watery diarrhea, though there was no episode of hematemesis and melena. A bruit was audible at the epigastric region. Abdominal angiograms demonstrated a first-sized portosystemic A-V fistula (PAVF) locating at the pancreas head, and suggested concomitant existence of portal hypertention.
On may 16, 1983, laparotomy was carried out in order to reduce portal pressure, but it was not successful. She died 3 weeks after the second operation.
Autopsy and pathological findings revealed that PAVF associated with a hen-egg-sized islet-cell tumor of the pancreas head. Etiology and clinical features of this rare entity may be characterized by the nature of the islet-cell tumor having rich and rapidly growing vascular supply.

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