Hemosuccus pancreaticus: diagnosis with CT and MRI and treatment with transcatheter embolization

Koizumi, Junzo; Inoue, Sanshiro; Yonekawa, Hajime; Kunieda, Takeharu

doi:10.1007/s00261-001-0041-8

Cited by 41 publications

(41 citation statements)

References 11 publications

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“…Therefore, if patients present with obscure source of repeated upper gastrointestinal bleeding, especially underlying chronic pancreatitis, repeated examinations and careful observations should be performed for the diagnosis of these conditions and HP should be included in differential diagnosis [9] . Koizumi et al [10] reported that MRI successfully identified the fistula and bleeding. However, MRI was not helpful for the diagnosis of HP in our cases, and reasons remain unknown.…”

Section: Discussionmentioning

confidence: 99%

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Toyoki¹,

Hakamada²,

Narumi³

et al. 2008

WJG

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Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment.

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Section: Discussionmentioning

confidence: 99%

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Toyoki¹,

Hakamada²,

Narumi³

et al. 2008

WJG

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“…При остром панкреатите про-теолитические энзимы поджелудочной железы при-водят к локальному воспалению, вследствие которого может происходить окклюзия соседних вен, а также способствуют появлению эрозий стенки артерий и образованию псевдоаневризм селезеночной, пече-ночной, верхней брыжеечной, гастродуоденальной и других артерий [12]. Для диагностики псевдоанев-ризм используют ультразвуковой метод исследова-ния с допплерографией, компьютерную томографию, магнитно-резонансную томографию [13,14]. «Золотым стандартом» диагностики является ангиография, ко-торая позволяет оценить размеры псевдоаневризмы, ее локализацию и осуществить вмешательство [15].…”

Section: Discussionunclassified

A successful outcome of treatment in a patient with a spleen artery aneurysm complicated by bleeding in pseudocyst of the pancreas

Халтурин¹,

Sergeev²,

Ахметзянов³

2017

PKiK

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A pseudoaneurysm is a rare and potentially dangerous vascular complication of acute pancreatitis, with a mortality of 20–43% in untreated patients. Its treatment includes embolization or surgical resection. A clinical case of a 39-year-old patient, with a history of chronic pancreatitis, pseudocyst of the tail of the pancreas, as well as a false aneurysm of the splenic artery detected by means of computed tomography of abdominal organs with contrast is presented. A two-stage surgical procedure was performed. The patient was discharged in a satisfactory condition. This case shows a successful use of diagnostic techniques, as well as a stage-by-stage approach to surgical treatment of this pathology.Received 20 April 2017. Accepted 7 June 2017.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: I.V. Halturin Data collection and analysis: I.V. Halturin Drafting the article: I.V. Halturin Resources: I.V. Halturin, S.A. Sergeev, R.G. Achmetzyanov Critical revision of the article: S.A. Sergeev, R.G. Achmetzyanov Final approval of the version to be published: I.V. Halturin, S.A. Sergeev, R.G. Achmetzyanov

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“…69,73 Contrast-enhanced computed tomography (CT) scans with angiography and MRI can be helpful in further characterization of the local anatomy and can help lead to the diagnosis in more than 90% of cases. 69,74 Both of these imaging modalities can help distinguish pancreatic masses, aneurysms, or pseudoaneurysms of the local vasculature, or anatomic variants, including pancreatic divisum. Occasionally, CT angiography can identify active bleeding if the rate of bleeding is at least 0.4 mL/ min.…”

Section: Hemosuccus Pancreaticusmentioning

confidence: 99%