Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Mitrović, M; Dugalić, Vladimir; Kovač, Jelena Djokić; Tadić, Boris; Milošević, Snežana; Lukic, Borivoje; Lekić, Nebojša; Cvetić, Vladimir

doi:10.3390/medicina56110617

Cited by 9 publications

(20 citation statements)

References 21 publications

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“…Modern interventional radiology provides minimally invasive endovascular treatment, which is increasingly used because of improved technical capabilities and low morbidity rates. 29 Angioembolization offers exceptional diagnostic and therapeutic possibilities for the precise identification and localization of the pseudoaneurysm. Additionally, exclusion of the blood vessel responsible for pseudoaneurysm formation from circulation can be achieved by stenting or embolization.…”

Section: Discussionmentioning

confidence: 99%

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Fatal gastrointestinal bleeding associated with acute pancreatitis as a complication of Covid-19: a case report

Mitrović¹,

Tadić

Janković³

et al. 2022

J Int Med Res

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Clinical manifestations of Covid-19 vary widely among patients. Recent studies suggest that up to 15% of patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections develop gastrointestinal symptoms. The location of virus–host cell receptors angiotensin-converting enzyme 2 and transmembrane serine protease 2 has an important role in the pathophysiology and presentation of disease. They are expressed in the respiratory tract, as well as other organs and tissues including exocrine and endocrine pancreatic cells. These cells are therefore a possible target for the virus, which could explain the relationship between SARS-CoV-2 infection and pancreatic injury. We report a disastrous collateral effect of the Covid-19 pandemic on a 33-year-old man with chronic renal insufficiency and asymptomatic SARS-CoV-2 infection, who developed acute pancreatitis. Inflammation progressed rapidly toward necrosis and the development of a peripancreatic pseudoaneurysm which subsequently ruptured, causing death.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, exclusion of the blood vessel responsible for pseudoaneurysm formation from circulation can be achieved by stenting or embolization. 29,30…”

Section: Discussionmentioning

confidence: 99%

Fatal gastrointestinal bleeding associated with acute pancreatitis as a complication of Covid-19: a case report

Mitrović¹,

Tadić

Janković³

et al. 2022

J Int Med Res

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“…9 Mitrovic et al showed the endoscopic coil embolisation of posterior IPDA by a technique called "sandwich technique". 10 In our case report we present to you, the pseudoaneurysm of the posterior IPDA with the metallic coiling by interventional radiology team once the hemodynamic stabilisation was achieved within 72 hours.…”

Section: Discussionmentioning

confidence: 91%

A rare case of pseudoaneurysm of posterior inferior pancreaticoduodenal artery related with hemosuccus pancreaticus: a case report

et al. 2022

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Hemosuccus pancreaticus is a rare cause of obscure and intermittent upper GI bleeding, often life threatening. Usually seen in a patient with chronic alcoholic pancreatitis complicated with pseudoaneurysm of splenic artery in most of the cases. In the given case reports it was pseudoaneurysm of the posterior branch of inferior pancreaticoduodenal artery (IPDA) which accounts for less than 0.07% of total 10% of pseudoaneurysm of visceral arteries caused by hemosuccus pancreaticus. These patients usually present with an obscure moderate upper GI bleed. Early clinical, endoscopic and radiological diagnosis helps to determine the appropriate method of management. Most of the cases require the endovascular interventions like glue embolisation or metal coiling or beads, very few cases end up with explorative laparotomy. Here we report a rare case presentation of upper GI bleed due to pseudoaneurysm of IPDA in hemosuccus pancreaticus, it’s diagnosis and management.

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“…Furthermore, localizing the blood vessels surrounding a cyst is of great importance to confirm the optimal puncture site for EUS-guided drainage. Color Doppler can also be used to avoid vascular structures if needed[ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Multiple hidden vessels in walled-off necrosis with high-risk bleeding: Report of two cases

Zhai

et al. 2021

WJCC

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BACKGROUND Walled-off necrosis (WON), as a local complication of acute necrotizing pancreatitis, is difficult to differentiate from pancreatic pseudocysts (PPC). Imaging modalities such as computed tomography show a lower accuracy than endoscopic ultrasound (EUS) in confirming the diagnosis. EUS-guided cystogastrostomy following direct endoscopic necrosectomy has achieved excellent results and has been regarded as a preferred alternative to traditional surgery. However, high-risk bleeding is one of the greatest concerns. CASE SUMMARY Two patients with symptomatic pancreatic fluid collections (PFCs) were admitted to our hospital for EUS-guided lumen-apposing metal stent therapy. The female patient suffered from intermittent abdominal pain and underwent two perioperative CT examinations. The male patient had recurrent pancreatitis and showed a growing PFC. The initial diagnosis was a PPC according to contrast-enhanced CT. However, the evidence of solid contents on EUS prompted revision of the diagnosis to WON. An endoscope was inserted into the cavity, and some necrotic debris and multiple hidden vascular structures were observed. Owing to conservative treatment by irrigation with sterile water instead of direct necrosectomy, we successfully avoided damaging hidden vessels and reduced the risk of intraoperative bleeding. CONCLUSION The application of EUS is helpful for the identification of PFCs. Careful intervention should be conducted for WON with multiple vessels to prevent bleeding.

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Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Cited by 9 publications

References 21 publications

Fatal gastrointestinal bleeding associated with acute pancreatitis as a complication of Covid-19: a case report

Fatal gastrointestinal bleeding associated with acute pancreatitis as a complication of Covid-19: a case report

A rare case of pseudoaneurysm of posterior inferior pancreaticoduodenal artery related with hemosuccus pancreaticus: a case report

Multiple hidden vessels in walled-off necrosis with high-risk bleeding: Report of two cases

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