Acute necrotizing pancreatitis complicated with pancreatic pseudoaneurysm of the superior mesenteric artery: A case report

He, Qing; Liu, Yueqin; Yuan, Liu; Guan, Yong-Song

doi:10.3748/wjg.14.2612

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…SMA pseudoaneurysm has been reported in literature in different clinical settings like post pancreatic surgery and acute or chronic pancreatitis. [6][7][8][9][10][11][12][13] Two large series comprising of 68 patients with vascular complications in relation to pancreatitis have reported only one case of pseudoaneurysm arising from SMA similar to our experience. 12,13 However, so far no case has been reported with respect to pseudoaneurysm from IPA.…”

Section: Discussionsupporting

confidence: 55%

Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis

Nagar

Dubale²,

Jagadeesh³

et al. 2011

jig

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Section: Discussionsupporting

confidence: 55%

Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis

Nagar

Dubale²,

Jagadeesh³

et al. 2011

jig

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“…4 Formation of arterial pseudoaneurysms is a consequence of enzymatic corrosion of tissues. Many different risk factors contribute to formation of pseudoaneurysms, including necrotizing pancreatitis, multiple organ failure, accumulation of pancreatic fluids, and abscesses.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurisma de aorta abdominal como complicação de pancreatite crônica: relato de caso

Barbosa¹,

Nóbrega²,

Rodrigues³

et al. 2017

J. vasc. bras.

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Chronic pancreatitis can be complicated by several vascular disorders, such as bleeding pseudocysts, thrombosis of the venous portal system, varicosities, and pseudoaneurysms. Pseudoaneurysm of the abdominal aorta secondary to chronic pancreatitis is a rare complication. It is a challenging clinical situation, demanding a high degree of clinical suspicion, and requires complex therapeutic procedures. The pathophysiology of this condition involves interstitial liberation and activation of enzymes from the exocrine pancreatic glands and subsequent digestion of the surrounding tissues. In the present case report, we describe a 52-year-old patient complaining of diffuse abdominal pains. Clinical investigation revealed chronic alcoholism and imaging examinations showed a pseudoaneurysm of the infrarenal aorta. We decided to perform conventional surgical treatment after considering the patient' s age and clinical status and the endoprostheses available at our hospital with diameters compatible with the patient' s aorta.Keywords: pseudoaneurysm; abdominal aorta; pancreatitis. ResumoA pancreatite crônica é uma enfermidade associada a diversas complicações vasculares, como pseudocisto hemorrágico, trombose do sistema venoso portal e formações varicosas e pseudoaneurismáticas. O pseudoaneurisma de aorta abdominal secundário à pancreatite crônica é uma complicação rara, de difícil suspeição clínica, que requer tratamento complexo. A fisiopatologia dessa condição envolve a corrosão enzimática tecidual após a liberação e ativação de enzimas exócrinas proteolíticas das células acinares do pâncreas. O presente estudo relata o caso de um paciente de 52 anos, etilista crônico, internado com dor abdominal difusa, cuja propedêutica revelou se tratar de um pseudoaneurisma em aorta infrarrenal. Optou-se pelo tratamento cirúrgico convencional, levando-se em consideração a idade, as condições clínicas do paciente e a disponibilidade de endopróteses compatíveis com o diâmetro da aorta.Palavras-chave: pseudoaneurisma; aorta abdominal; pancreatite.

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“…It has been reported that pseudoaneurysms at the celiac and superior mesenteric arteries were caused by inflammatory extension of the acute pancreatitis. 28,29 In patients with a Type 1 pathway, inflammation is thought to more easily extend these arteries through the right retromesenteric plane compared with patients with a Type 2 pathway because the descending duodenum plays a role as a barrier of inflammatory extension in a Type 2 pathway. Tumour invasion to the right mesenteric plane is one of the important criteria in TNM classification in patients with right renal cell carcinoma; the thickening of the right mesenteric plane on CT images is suggestive of tumour invasion and the patient is diagnosed as stage T4.…”

mentioning

confidence: 99%

Medial pathway patterns of the right retromesenteric plane: anatomical investigation using MDCT in patients with acute pancreatitis and pyelonephritis

Takaji

Mori

Yamada

et al. 2016

BJR

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Objective: To investigate the medial pathways of the right retromesenteric plane by reviewing multidetector CT (MDCT) findings in patients with acute pancreatitis and pyelonephritis. Methods: 112 patients with acute pancreatitis and 114 patients with pyelonephritis underwent MDCT scans. 64 of the 112 patients with acute pancreatitis and 34 of the 114 patients with pyelonephritis had right retromesenteric plane thickening because of inflammatory extensions. The medial pathways of the right retromesenteric plane were evaluated by two radiologists in consensus. Results: In 18 (28%) of the 64 patients with acute pancreatitis and 10 (29%) of the 34 patients with pyelonephritis, the right retromesenteric plane continued to the central retroperitoneum behind the descending duodenum and pancreatic head (Type 1 pathway). The right retromesenteric plane extended to the right wall of the descending duodenum (Type 2 pathway) in 46 patients (72%) with acute pancreatitis and 24 patients (71%) with pyelonephritis. There was no significant difference in the pathway patterns of the right retromesenteric plane between the acute pancreatitis group and the pyelonephritis group (Type 1 pathway, p 5 0.89; Type 2 pathway, p 5 0.76). Conclusion: Two patterns were confirmed regarding the medial pathways of the right retromesenteric plane; this anatomical knowledge is important for evaluating the extension of retroperitoneal diseases. Advances in knowledge: Medial aspect of the right retromesenteric plane is thought to have two pathways. The right retromesenteric plane continuing to the right duodenal wall is a common type. Knowledge of these variations is important when evaluating the retroperitoneal diseases.

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Acute necrotizing pancreatitis complicated with pancreatic pseudoaneurysm of the superior mesenteric artery: A case report

Cited by 3 publications

References 8 publications

Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis

Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis

Pseudoaneurisma de aorta abdominal como complicação de pancreatite crônica: relato de caso

Medial pathway patterns of the right retromesenteric plane: anatomical investigation using MDCT in patients with acute pancreatitis and pyelonephritis

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