A rare case of anterior abdominal wall arteriovenous malformation

Arteriovenous malformation most commonly affects the central nervous system but can involve any organ. A 28 year old woman presented with complaints of on and off pain in epigastric region since 3 month.skin lesion in epigastric region since one month. local examination, there was multiple clear to hemorrhagic fluid filled blister present in epigastric region. An ill defined mass in the epigastric region, soft to firm in consistency and immobile. On leg raising test, the swelling became prominent. MDCT scan of whole abdomen showed a single lobulated hypodense lesion in anterior abdominal wall. Arterial supply was from superior epigastric artery from both sides and inferior epigastric artery from left side. There was no involvement of rectus sheath or evidence of intra-peritoneal extension. Excision of the epigastric AVM was performed after ligating all the feeders. To our best knowledge, this is the first case of epigastric subcutaneous AVM and such an entity has not been reported in the literature so far. Epigastric AVMs can easily be misdiagnosed as lipoma or epigastric hernia. Ultrasonography is useful as an initial imaging modality, however a CT scan is required to determine the peritoneal and visceral involvement of an epigastric mass.