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Canadian Journal of Gastroenterology
Volume 17, Issue 11, Pages 661-665
http://dx.doi.org/10.1155/2003/170969
Brief Communication

Embolization of a Duodenal Arteriovenous Malformation in Hereditary Hemorrhagic Telangiectasia: Case Report and Review of the Literature

Phil Inouye,1 Norman Marcon,2 Robin A Pugash,3 Robert H Hyland,4 and Marie E Faughnan4,5

1Department of Medicine, University of Toronto, Canada
2Division of Gastroenterology, Department of Medicine, St Michael’s Hospital, University of Toronto, Canada
3Department of Medical Imaging, University of Toronto, Department of Medical Imaging, Sunnybrook and Women’s College Health Sciences Centre, Canada
4Division of Respiratory Medicine, Department of Medicine, St Michael’s Hospital, University of Toronto, Canada
5Financial Support, Squires Club, Nelson Arthur Hyland Foundation, Sonor Foundation, St Michael’s Hospital Research Institute, Toronto, Ontario, Canada

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 68-year-old man with hereditary hemorrhagic telangiectasia presented with recurrent, intermittent gastrointestinal hemorrhage. Transfusion of a total of 27 units of red blood cells was required over the three months before admission. Upper and lower endoscopy did not reveal a source of bleeding and a technetium-labelled red blood cell scan was noncontributory. Angiography demonstrated a duodenal arteriovenous malformation originating from a superior mesenteric artery branch. Embolization of the arteriovenous malformation was performed with resolution of gastrointestinal hemorrhage and reduced requirement for blood transfusion. The utility of trans-catheter embolization in the management of duodenal arteriovenous malformations in hereditary hemorrhagic telangiectasia is discussed.