Arteriovenous gastric malformation: A challenging diagnosis. A case report

Sana Landolsi; Aymen Saidi; Soumaya Ncibi; Lamia Kallel; Imen Ridene; Faouzi Chebbi

doi:10.1016/j.ijscr.2023.108880

Arteriovenous gastric malformation: A challenging diagnosis. A case report

Int J Surg Case Rep. 2023 Oct:111:108880. doi: 10.1016/j.ijscr.2023.108880. Epub 2023 Sep 30.

Authors

Sana Landolsi¹, Aymen Saidi², Soumaya Ncibi³, Lamia Kallel³, Imen Ridene⁴, Faouzi Chebbi²

Affiliations

¹ University of Tunis El Manar, Faculty of medicine of Tunis, Department of surgery, Mahmoud El Matri Hospital, Ariana, Tunisia. Electronic address: sana.landolsi@fmt.utm.tn.
² University of Tunis El Manar, Faculty of medicine of Tunis, Department of surgery, Mahmoud El Matri Hospital, Ariana, Tunisia.
³ University of Tunis El Manar, Faculty of medicine of Tunis, Department of gastro-enterology, Mahmoud El Matri Hospital, Ariana, Tunisia.
⁴ University of Tunis El Manar, Faculty of medicine of Tunis, Department of radiology, Mahmoud El Matri Hospital, Ariana, Tunisia.

Abstract

Introduction: Gastro-intestinal bleeding etiological diagnosis could be challenging especially for rare etiologies as it was the case of our patient having an arteriovenous gastric malformation.

Case presentation: A 50-years old man consulted for hematemesis. Esophagogastroduodenoscopy didn't show bleeding signs. Angio-scan revealed an arteriovenous gastric malformation. Median laparotomy revealed multiple radiologically unsuspected great omentum arteriovenous malformations and confirmed the existence of this arteriovenous malformation in the posterior part of the lesser curvature guided by per-operative esophagogastroduodenoscopy. Atypical gastrectomy was performed.

Discussion: Our case illustrated a rare life-threatening condition with a challenging diagnosis. Arteriovenous gastric malformation accounted for 1 to 2 % of nonvariceal upper gastrointestinal bleeding. Great omentum localization corresponded to an exceptional condition that had been reported in only one adult patient and one childhood case. Its pathogenesis is still unknown.

Conclusions: Arteriovenous gastric malformation had to be considered in case of normal endoscopic esophagogastroduodenoscopy. Computed tomography had to be done for both diagnosis and therapeutic purposes.

Keywords: Arteriovenous malformation; Case report; Gastric vascular malformation; Surgery.

Publication types

Case Reports