SUMMARY Pure pancreatic juice has been collected from 61 patients at the time of endoscopic retrograde cholangio-pancreatography (ERCP) for the purpose of cytodiagnosis. The ERCP and cytological findings are discussed. Pure pancreatic juice cytology may help in the interpretation of the pancreatogram in both pancreatitis and pancreatic carcinoma. In patients with pancreatic carcinoma, ERCP alone was diagnostic in 65%, cytology alone in 54%. By combining these two approaches, a diagnostic result was obtained in 92 % of patients.
SUMMARY Chronic pancreatitis is known to cause vascular lesions, which produce gastrointestinal haemorrhage. Visceral vessel aneurysms are an unexpectedly common finding in arteriograms of patients with chronic pancreatitis. Gastrointestinal bleeding from these aneurysms carries a high mortality, making early diagnosis and treatment essential. Coeliac and mesenteric arteriography readily confirm the diagnosis. Surgical ligation or resection of the aneurysm entails a high mortality. Cessation of such gastrointestinal haemorrhage may be achieved by transcatheter embolisation under radiological control. This report describes a case in which bleeding from a gastroduodenal artery aneurysm, caused by chronic pancreatitis, was successfully treated by embolisation using a Gianturco coil.Gastrointestinal haemorrhage is a recognised complication of chronic pancreatitis and has been reported to occur in up to 9% of cases.' Several aetiological factors such as local venous hypertension secondary to splenoportal thrombosis, erosion of vessels in the walls of neighbouring viscera, formation of visceral vessel aneurysms and bleeding from a pseudocyst into the pancreatic duct, have been described to account for the gastrointestinal haemorrhage.' The incidence of visceral vessel aneurysms, detected by coeliac arteriography, in cases of chronic pancreatitis has been reported to be as high as 10%.2 Erosion and weakening of the arterial wall, responsible for aneurysm formation, is primarily because of the enzymatic actions of elastase and trypsin, which are released in large amounts in pancreatitis.3 The majority of such aneurysms occur on the splenic artery and a few occur on the common hepatic, gastroduodenal and pancreatic-duodenal arteries. Half of these aneurysms rupture and cause gastrointestinal bleeding,4 which has -a high mortality. Often surgical ligation or resection of the bleeding aneurysm is hazardous or not possible.7 Selective embolisation of the aneurysm by delivering an occluding agent
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