Spontaneous retroperitoneal hematoma caused by aneurysm of the inferior pancreaticoduodenal artery

Kabaroudis, A.; Papaziogas, B.; Papaziogas, T.

doi:10.1016/s0002-9610(02)00901-7

Cited by 17 publications

(12 citation statements)

References 2 publications

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“…However, a PDAA can also start clinically as a duodenal obstruction, right-upper quadrant abdominal pain or any other unspecific symptom due to a retroperitoneal hematoma (9). Interestingly, the risk of rupture of a PDAA is not related to its diameter (10).…”

Section: Discussionmentioning

confidence: 99%

Endovascular therapy as a treatment for ruptured pancreaticoduodenal artery aneurysms

Cano-Valderrama¹,

Gallego-Béuter²,

Giner³

2011

Minimally Invasive Therapy & Allied Technologies

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Pancreaticoduodenal artery aneurysms (PDAAs) are uncommon. The treatment and prognosis for ruptured PDAAs have changed in recent years. A demonstrative case is reported. A review of the literature has been made and the case of a healthy man operated on an emergency basis because of a massive hemoperitoneum secondary to a ruptured PDAA is reported and analyzed with regard to the clinical presentation, radiologic findings, management, and outcome. A bleeding point was not detected at operation. An intraoperative arteriogram did not show active bleeding. The pancreas appeared infiltrated and oozing blood. The abdomen was gauze packed and the patient transferred for endovascular therapy (ET). Then, an arteriogram showed a bleeding PDAA. After embolization, bleeding ceased and the patient recovered. According to our literature survey, less than 200 cases of true and false PDAAs have been reported. For ruptured PDAAs, surgery is associated with high mortality since the bleeding point is usually not identified at operation. Similarly, intraoperative arteriograms are often fruitless due to the patient's poor hemodynamics plus suboptimal quality of the portable equipment. As shown in the present case and according to the specialized medical literature, ET has often been successful in the management of these patients and may be chosen as a first option for the treatment of ruptured PDAAs.

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Section: Discussionmentioning

confidence: 99%

Endovascular therapy as a treatment for ruptured pancreaticoduodenal artery aneurysms

Cano-Valderrama¹,

Gallego-Béuter²,

Giner³

2011

Minimally Invasive Therapy & Allied Technologies

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“…Both CT and MRI are suitable for the diagnosis of retroperitoneal haematoma, although MRI has its advantages3 in being superior to differentiate between abscesses, haematomas and tumours 4. Spontaneous retroperitoneal haematoma can occur as a complication of an aneurysm rupture.…”

Section: Discussionmentioning

confidence: 99%

Acute abdomen due to retroperitoneal haematoma: a surgical dilemma

Jose

Achuthan²,

Sagar³

2009

Case Reports

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A 73-year-old man presented with features of acute abdomen 2 days following evacuation of a subdural haematoma. CT scan demonstrated significant free fluid in the peritoneal cavity as well as an extensive abnormal area in the upper retroperitoneum. There was no obvious free gas or leak of contrast. As there was persistent metabolic acidosis and significant peritonism, the patient proceeded to an exploratory laparotomy. This revealed a large non-expanding retroperitoneal haematoma and free blood in the peritoneal cavity. There was no evidence of active bleeding and the bowel was found to be viable. As the patient was haemodynamically stable, a laparostomy was fashioned and the patient subsequently underwent angiography. This revealed a 1.5 cm pseudoaneurysm arising from the superior mesenteric artery which was treated with coil embolisation. The patient made an uneventful recovery and the laparostomy was closed.

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“…In contrast, the detection of pancreaticoduodenal artery aneurysms during surgery may fail in approximately 70% of cases [12,20] because of their localization behind or within the parenchyma of the pancreas. Surgery may be questionable because arterial ligation (with or without aneurysm resection) is not always feasible, and partial pancreatectomy can be necessary [17][18][19]. In one patient in whom we tried to perform transcatheter arterial embolization 12 years ago, we could not even pack the aneurysm (i.e., we embolized only the afferent artery with microcoils).…”

Section: Discussionmentioning

confidence: 99%

Management of Pancreaticoduodenal Artery Aneurysms: Results of Superselective Transcatheter Embolization

Murata

Tajima

Fukunaga

et al. 2006

American Journal of Roentgenology

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Spontaneous retroperitoneal hematoma caused by aneurysm of the inferior pancreaticoduodenal artery

Cited by 17 publications

References 2 publications

Endovascular therapy as a treatment for ruptured pancreaticoduodenal artery aneurysms

Endovascular therapy as a treatment for ruptured pancreaticoduodenal artery aneurysms

Acute abdomen due to retroperitoneal haematoma: a surgical dilemma

Management of Pancreaticoduodenal Artery Aneurysms: Results of Superselective Transcatheter Embolization

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