Spontaneous thrombosis of a pseudoaneurysm complicating pancreatitis

Vanlangenhove, Peter; Defreyne, Luc; Kunnen, Marc

doi:10.1007/s002619900546

Cited by 23 publications

(13 citation statements)

References 17 publications

(13 reference statements)

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“…For this reason, we support the premise that preventive measures such as endovascular intervention or surgery should be undertaken as soon as the pseudoaneurysm is discovered. With respect to the treatment of acute bleeding or arterial pseudoaneurysms, surgery and endovascular techniques are the two primary options (21)(22)(23). The former is often challenging, especially when there is severe inflammation, and there is often the need to simultaneously perform necrosectomy and debridement along with pancreatectomy or splenectomy (1).…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Udd et al 8 attempted to address this specific issue and identified a post-embolisation complication rate of 17% 4,23 in patients undergoing angioembolisation for bleeding pseudoaneurysms secondary to CP. The complications consisted of one coil being pushed into the main pancreatic duct and requiring endoscopic removal; one dissection of the bleeding artery (which led to bleeding cessation); one coil being pushed into the iliac artery and requiring operative intervention; and one pseudoaneurysm at the angiography inguinal puncture site.…”

Section: Coil Migration -A Rare Complication Of Endovascular Exclusiomentioning

confidence: 99%

“…10 Massive haemorrhage into the gastrointestinal (GI) tract or peritoneal cavity from VAPAs can result in death in 20-40% of cases. 9,11,12 Whereas spontaneous thrombosis has been described rarely, 4 VAPAs usually require treatment in the form of surgical, 13 endovascular, 14 or combined approaches. 5 We describe a case, and review all similar reports, of coil migration following endovascular exclusion of a visceral artery pseudoaneurysm.…”

Section: Introductionmentioning

confidence: 99%

“…Visceral artery pseudoaneurysms or aneurysms (VAPA) of the splenic, 1 gastroduodenal, 2, 3 hepatic, 2 gastroepiploic, 4 superior mesenteric 5 or inferior mesenteric 6 (or any visceral branch of the coeliac axis, inferior mesenteric, superior mesenteric or renal arteries) arteries can form secondary to a variety of congenital, traumatic and inflammatory pathologies. Visceral artery aneurysms are found in 0.01-0.2% of routine autopsies but are being increasingly found incidentally in our ageing population; 7 whereas visceral artery pseudoaneurysm formation is a rare but potentially fatal complication occurring in less than 2% of cases of chronic pancreatitis (CP), 8 and even less frequently following acute pancreatitis and hepatopancreaticobiliary (HPB) surgery, 9 vasculitis or other inflammatory processes.…”

Section: Introductionmentioning

confidence: 99%

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Coil migration – a rare complication of endovascular exclusion of visceral artery pseudoaneurysms and aneurysms

Skipworth

Morkane

Raptis

et al. 2011

annals

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INTRODUCTIONWe describe a case of metallic, angiographic coil migration, following radiological exclusion of a gastroduodenal artery pseudoaneurysm secondary to chronic pancreatitis. PATIENTS AND METHODS A 55-year-old man presented to the out-patient clinic with chronic, intermittent, post-prandial, abdominal pain, associated with nausea, vomiting and weight loss. He was known to have chronic pancreatitis and liver disease secondary to alcohol abuse and previously underwent angiographic exclusion of a gastroduodenal artery pseudoaneurysm. During subsequent radiological and endoscopic investigation, an endovascular coil was discovered in the gastric pylorus, associated with ulceration and cavitation. This patient was managed conservatively and enterally fed via naso-jejunal catheter endoscopically placed past the site of the migrated coil. This patient is currently awaiting biliary bypass surgery for chronic pancreatitis, and definitive coil removal will occur concurrently. CONCLUSIONS Literature review reveals that this report is only the eighth to describe coil migration following embolisation of a visceral artery pseudoaneurysm or aneurysm. Endovascular embolisation of pseudoaneurysms and aneurysms is generally safe and effective. More common complications of visceral artery embolisation include rebleeding, pseudoaneurysm reformation and pancreatitis.

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“…PGDA are rare [1,2] and spontaneous thrombosis of these occurs only under certain conditions [3]. These usually occur secondary to pancreatitis or postoperative or as a complication of some procedure for e.g.…”

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confidence: 99%

A rare case of ‘Spontaneous rupture of partially thrombosed pseudoaneurysm of gastroduodenal artery associated with chronic pancreatitis’

et al. 2009

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Spontaneous thrombosis of a pseudoaneurysm complicating pancreatitis

Cited by 23 publications

References 17 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

Coil migration – a rare complication of endovascular exclusion of visceral artery pseudoaneurysms and aneurysms

A rare case of ‘Spontaneous rupture of partially thrombosed pseudoaneurysm of gastroduodenal artery associated with chronic pancreatitis’

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