Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Ding, Xiangjiu; Zhu, Jiankang; Zhu, Min; Li, Caixia; Jian, Wencheng; Jiang, Jianjun; Wang, Zhanmin; Hu, Sanyuan; Jiang, Xu-sheng

doi:10.1007/s11605-011-1561-3

Cited by 60 publications

(54 citation statements)

References 36 publications

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“…Conversely, pseudoaneurysms must be immediately treated as the rupture rate is much greater than true aneurysms (76.3% versus 3.1%) [11,17]. Endovascular management is safe and effective, including fewer complications, shorter hospital stay and recovery [4,18,19]. There are various methods for endovascular treatment, including the placement of coils, stent implantation, injection of polyvinyl alcohol particles, gelfoam or glue, and endoluminal thrombin injection [4,20,21].…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Júnior¹,

Beck²,

Perotoni³

et al. 2017

Vasc Med Surg

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Aneurysms of the middle colic arterial branches are extremely rare, the main manifestation occurs due to the rupture and intraabdominal bleeding making death possible in up to 70% of cases. Herein, we report a case of a male patient, who is 50 years old and displays intermittent, recurrent, and self-limited episodes of a digestive hemorrhage that has been symptomatic during the course of a three-month investigation. After an extensive investigation, the patient was submitted to angiography detecting a pseudoaneurysm in the middle colic branch, being treated by embolization using micro-coils. Intermittent digestive hemorrhages from an obscure source can represent a diagnostic challenge, due to the high degree of clinical suspicion for performing the correct differential diagnosis. Arteriography must not be delayed whenever a pseudoaneurysm with active bleeding is suspected, as this exam is selected for diagnosis and the preferred method for conclusive treatment.

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Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Júnior¹,

Beck²,

Perotoni³

et al. 2017

Vasc Med Surg

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“…Pseudoaneurysms are the most severe concern with regard to post-pancreatoduodenectomy bleeding, occurring in approximately 3.2e4.6% of cases [5,6]. Often arising in the setting of pancreatic fistula, inflammation and irritation of the vasa vasorum leads to weakness in the visceral arterial walls.…”

Section: Discussionmentioning

confidence: 99%

“…In the postoperative patient, bleeding from the gastrointestinal tract or surgical drain is the most common presentation [7]. As many as fortyfive percent of pseudoanuerysms may present with a sentinel bleed [5], which often times goes unrecognized. One institutional study reported a median time of occurrence of twenty-two days postoperatively, though later presentations have been reported as well [7].…”

Section: Discussionmentioning

confidence: 99%

An unusual case of late gastrointestinal bleeding after pancreatoduodenectomy

et al. 2014

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“…The aneurysms can be treated through endovascular techniques or by surgery [8]. Treatment depends on the presentation, location, and size of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Damage control surgery in patient with delayed rupture of pseudoaneurysm after blunt abdominal trauma

Park

Kim

2012

J Korean Surg Soc

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Delayed rupture of post-traumatic pseudoaneurysms of the visceral arteries, especially the pancreaticoduodenal artery, is uncommon. Here, we describe a 55-year-old man hemorrhaging from a pseudoaneurysm of the inferior pancreaticoduodenal artery (IPDA). Computed tomography of the abdomen showed active bleeding in the IPDA and large amounts of hemoperitoneum and hemoretroperitoneum. Selective mesenteric angiography showed that the pseudoaneurysm arose from the IPDA, and treatment by angioembolization failed because the involved artery was too tortuous to fit with a catheter. Damage control surgery with surgical ligation and pad packing was successfully performed. The patient had an uncomplicated postoperative course and was discharged 19 days after the operation. To our knowledge, this is the first report of ruptured pseudoaneurysm of an IPDA after blunt abdominal trauma from Korea.

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Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Abstract: Endovascular intervention represents the first-line treatment for hemorrhage from pseudoaneurysms after pancreatic surgery. Endovascular embolization or stent-graft placement should be selected individually depending on the involved artery and its vascular anatomy.

Cited by 60 publications

References 36 publications

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

An unusual case of late gastrointestinal bleeding after pancreatoduodenectomy

Damage control surgery in patient with delayed rupture of pseudoaneurysm after blunt abdominal trauma

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