Pancreatic arteriovenous malformations (PAVMs) are uncommon abnormalities of pancreatic blood vessels that result in direct, high-flow connections between arteries and veins. There are currently fewer than 200 reported cases in the literature of this particular anomaly. They are often clinically asymptomatic but may present with abdominal pain, gastrointestinal bleeding, or features of portal hypertension, and can resemble cystic or neoplastic lesions on imaging. We report a case of a 48-year-old female with a pancreatic head mass presenting with non-specific abdominal pain and jaundice. Owing to diagnostic uncertainty and biliary obstruction, an open, stomach-preserving pancreaticoduodenectomy was performed. Intraoperatively, a tense blood-filled cyst was identified; histopathology demonstrated an organised haematoma with abnormal vascular channels consistent with a pancreatic arteriovenous malformation. This case highlights the diagnostic challenge posed by pancreatic arteriovenous malformations and supports surgical resection as definitive management when malignancy or obstruction cannot be confidently excluded.
Krishnan et al. (2026) studied this question.