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Large pulmonary arteriovenous malformation with hyperammonemia

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Abstract

A 45-year-old female presented with generalized fatigue, unaccompanied by other symptoms. Investigation revealed severe anemia due to gastric bleeding, and hereditary hemorrhagic telangiectasia accompanied by a large pulmonary arteriovenous malformation (PAVM). Additionally, the presence of hepatic arteriovenous and portovenous shunts indicated hepatic involvement. In addition to hypoxemia due to right-to-left shunting in PAVM, hyperammonemia with normal hepatic function was detected. The large PAVM was successfully managed with surgical resection. Hyperammonemia, persisting despite the hemostasis of gastric bleeding, improved postoperatively in the absence of treatment directed at hepatic involvement. We believe that resection of large PAVM contributed to the improvement of hyperammonemia.

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Authors and Affiliations

  1. From Division of Frontier Medical Science, Department of Surgery, Programs for Biomedical Science Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan

    Teruhisa Takuwa MD, Shinkichiro Yoshioka MD, Yoshihiro Miyata MD, Seiji Fujisaki MD, Yukari Zenke MD & Toshimasa Asahara MD

Authors
  1. Teruhisa Takuwa MD
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  2. Shinkichiro Yoshioka MD
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  3. Yoshihiro Miyata MD
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  4. Seiji Fujisaki MD
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  5. Yukari Zenke MD
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  6. Toshimasa Asahara MD
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Takuwa, T., Yoshioka, S., Miyata, Y. et al. Large pulmonary arteriovenous malformation with hyperammonemia. Jpn J Thorac Caridovasc Surg 52, 484–487 (2004). https://doi.org/10.1007/s11748-004-0146-4

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  • DOI: https://doi.org/10.1007/s11748-004-0146-4

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