Arterial Complications of Pancreatitis: Diagnostic and Therapeutic Aspects in 104 Cases

Boudghene, F; L’Herminé, C; Bigot, Jean-Michel

doi:10.1016/s1051-0443(93)71920-x

Cited by 193 publications

(107 citation statements)

References 19 publications

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“…While the recurrence rate in the study by Boudghene et al (29) was as high as 37%, in the study by Sethi et al (30), there were no episodes of rebleeding and no in-hospital mortality. In our study, only three patients showed signs of rebleeding, two of whom were succesfully treated by a second embolization procedure, leaving only one case of failed hemostasis.…”

Section: Discussionmentioning

confidence: 74%

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Kim¹,

Shin²,

Yoon³

et al. 2015

Diagn Interv Radiol

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thirty-seven patients underwent endovascular intervention for the management of pancreatitis-related hemorrhage. The underlying etiology of the disease, clinical symptoms and laboratory findings, abnormalities seen on computed tomography, and details regarding the endovascular procedures were assessed, as were the outcome of each procedure and procedure-related complications. RESULTSA total of 41 endovascular procedures were performed in 37 patients. The splenic artery (34.8%) was the most commonly treated artery, and pseudoaneurysm was the most commonly detected abnormality on digital subtraction angiography (78.3%). Transcatheter embolization was performed in the majority of patients (95.1%), while two patients were treated with stent-grafts. Successful hemostasis without rebleeding was achieved in 34 patients (91.9%). Two cases of rebleeding were successfully treated by reintervention. Focal splenic infarction, which developed in eight patients, was either asymptomatic or accompanied by mild, transient fever. Splenic abscess was the only major complication occurring in three patients. Two of these patients died from resulting sepsis, while the third recovered after antibiotic treatment. CONCLUSION Endovascular management is effective for achieving hemostasis in patients with pancreatitis-related bleeding and demonstrates low recurrence and mortality rates.

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Section: Discussionmentioning

confidence: 74%

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Kim¹,

Shin²,

Yoon³

et al. 2015

Diagn Interv Radiol

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Boudfhene [11] performed angiography in hemorrhagic lesions of the pancreatitis and found a false aneurysm in 45 (48%) of 93 patients. In the same series [11], contrast-enhanced CT detected a false aneurysm in 16 of 73 cases (22%). Marshall [12] discussed the detection of false aneurysms in five cases with bleeding pancreatic pseudocysts as follows: two cases (40%) in dynamic CT and four cases (80%) in angiography.…”

Section: Discussionmentioning

confidence: 99%

Minute Splenic Pseudoaneurysm Causing Hemorrhage within a Pancreatic Pseudocyst: The Utility of CT during Splenic Arteriography

Ogawa¹,

Tajima²,

Shida³

et al. 2017

JCR

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Background: Chronic pancreatitis with pseudocyst complicated by hemorrhage has a poor prognosis. Case Report: A 50-year-old Japanese male, known case of pancreatic pseudocyst presented with upper abdominal pain. Emergency CT demonstrated a hyper-attenuated area within the pancreatic pseudocyst, indicating a fresh hemorrhage. However, dynamic contrast-enhanced CT showed neither contrast extravasation nor pseudoaneurysm. Because laboratory data showed an increased serum level of pancreatic enzyme, diagnosis of acute exacerbation of chronic pancreatitis was considered. An arterial hemorrhage within the pancreatic pseudocyst was suspected, and angiography was performed to identify the bleeding site. The splenic angiography initially showed no definite findings of pseudoaneurysm or extravasation. CT during splenic arteriography revealed a splenic artery aneurysm and irregularity of the splenic artery branch at the proximal site of the pseudoaneurysm. Transcatheter arterial embolization was performed to prevent arterial bleeding from the pseudoaneurysm, and the injured segment of the splenic artery was embolized using 12 microcoils with an isolation method. Conclusion: Selective CT arteriography using interventional CT equipment might be useful in the three-dimensional evaluation of a minute or ambiguous visceral aneurysm on transvenous contrast-enhanced CT and selective angiograms.

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“…Surgical treatment, particularly in hemorrhagic pseudocysts, is a well-known and highly successful approach in experienced hands. However, the dense inflammatory adhesions in the surgical bed and high operative mortality rate may sometimes cause concern and hesitation in using this option (12,13). The location of the pseudoaneurysm in the pancreas is also mentioned as a potential indicator of surgery (2).…”

Section: Discussionmentioning

confidence: 99%

Intrapancreatic pseudoaneurysm causing massive gastrointestinal hemorrhage and chronic pancreatitis

Peynircioğlu

Karaosmanoğlu²,

İdilman³

et al. 2015

Turk J Gastroenterol

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Pseudoaneurysms of the splenic artery is a well-known complication of pancreatitis. However, to the best of our knowledge, a subcentimetric intrapancreatic pseudoaneurysm (without an associated pseudocyst) causing massive gastrointestinal bleeding and distal main pancreatic duct obstruction is a rare clinical phenomenon. Herein, we present such a unique complication with computed tomography images and subsequent successful endovascular treatment.

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Arterial Complications of Pancreatitis: Diagnostic and Therapeutic Aspects in 104 Cases

Cited by 193 publications

References 19 publications

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Endovascular intervention for management of pancreatitis-related bleeding: a retrospective analysis of thirty-seven patients at a single institution

Minute Splenic Pseudoaneurysm Causing Hemorrhage within a Pancreatic Pseudocyst: The Utility of CT during Splenic Arteriography

Intrapancreatic pseudoaneurysm causing massive gastrointestinal hemorrhage and chronic pancreatitis

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