Arteriovenous gastric malformation: A challenging diagnosis. A case report

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.