Pancreatic Arteriovenous Malformation as an Unusual Cause of Chronic Gastrointestinal Bleeding in a Patient with Early Gastric Cancer: Multimodality Imaging Spectrum with Pathologic Correlation

Anemia is one of the most common causes of dizziness. Most chronic anemia is associated with gastrointestinal bleeding, such as peptic ulcers or cancer of various organs (1). Pancreatic arteriovenous malformation (AVM) is a rare cause of gastrointestinal bleeding (2). They are usually asymptomatic but may present with abdominal pain, portal hypertension in the absence of hepatopathy, or gastrointestinal bleeding. Although pancreatic AVM is rare, it should be considered in patients with anemia of unknown origin or those who failed therapy for more common causes of anemia. Even though previous studies have reported the imaging findings of pancreatic AVM including ultrasound, computed tomography, and magnetic resonance imaging, most Arteriovenous malformation (AVM) of the pancreas is extremely rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen. Early diagnosis of this disease is important to prevent delay of treatment and resulting fatal complications. We report a rare case of pancreatic AVM in a 48-year-old man who presented with severe chronic anemia and early gastric cancer, which made diagnosis challenging. Imaging findings, including ultrasound, computed tomography, and magnetic resonance imaging, are shown, as well as the pathologic features.