Treatment strategies for bleeding from gastroduodenal artery pseudoaneurysms complicating the course of chronic pancreatitis—A case series of 10 patients

Gupta, Vikas; Irrinki, Santhosh; Sakaray, Yashwanth Raj; Moond, Vikash; Yadav, Thakur Deen; Kochhar, Rakesh; Khandelwal, Niranjan; Wig, Jai Dev

doi:10.1007/s12664-018-0897-y

Cited by 14 publications

(12 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pseudoaneurysm formation is found to be more common (80%) in patients where alcohol abuse is an underlying etiological factor [13,14]. During the process of formation and enlargement, a WOPN engages adjacent vessels into its wall.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are no randomized prospective studies, numerous reports have shown excellent results of endovascular treatment in this group of high-risk patients. To date, angioembolization has been considered the most appropriate treatment option for treatment of visceral pseudoaneurysms associated with pancreatitis and the power tool for achieving hemostasis [14,18]. When endovascular embolization is not possible due to anatomical reasons, thrombin injection, as a cheaper but more invasive procedure, may be the method of choice.…”

Section: Discussionmentioning

confidence: 99%

“…When endovascular embolization is not possible due to anatomical reasons, thrombin injection, as a cheaper but more invasive procedure, may be the method of choice. Thrombin injection is suitable for pseudoaneurysms with a narrow neck, while angioembolization is recommended for those with wide neck [14,23].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Mitrović¹,

Dugalić

Kovač

et al. 2020

Medicina

View full text Add to dashboard Cite

Pancreatic pseudoaneurysm is a rare but life-threatening clinical entity. In this paper, we present a case of a 74-year-old man, who was admitted to our clinic with a diagnosis of an acute on chronic pancreatitis complicated by walled-off-pancreatic-necrosis, with subsequent development of peripancreatic pseudoaneurysm. After initial conservative management, the patient recovered and was discharged from the hospital. However, he soon returned feeling anxious due to a pulsatile abdominal mass. Abdominal Color–Doppler examination, CT scan, and angiography revealed large pancreatic necrotic collection in the total size of 9 cm, with centrally enhancing area of 3.5 cm that corresponded to pseudoaneurysm originating from the posterior pancreaticoduodenal vascular arcade. Considering the size, location of the pseudoaneurysm, feeding vessel, and poor general patients condition, we opted for minimally invasive treatment. Pseudoaneurysm was successfully managed by endovascular coil embolization, i.e., “sandwich technique”.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Mitrović¹,

Dugalić

Kovač

et al. 2020

Medicina

View full text Add to dashboard Cite

show abstract

“…Presence of pseudoaneurysms as localized on angiography is a favorable situation as algorithm based directed therapy can be successfully carried out in this situation. 13 We reported splenic artery to be commonest site for pseudoaneurysm. Others have also observed similar findings.…”

Section: Discussionmentioning

confidence: 88%

“… 5 - 12 Most of the large reports on pseudoaneurysms associated with pancreatitis include both acute and chronic cases. 5 , 13 - 18 EPAMI (Epidemiología de la Pancreatitis Aguda en Medicina Intensiva) Study group has reported 11% incidence of abdominal haemorrhage in critically ill patients with pancreatitis across 46 intensive care units from Spain and Latin America. 12 Wei at al.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhage complicating the course of severe acute pancreatitis

Gupta

Krishna

Kochhar

et al. 2020

Ann Hepatobiliary Pancreat Surg

Self Cite

View full text Add to dashboard Cite

Backgrounds/Aims: The course of severe acute pancreatitis (SAP) complicated by hemorrhage is associated with poor outcome. Methods: Twenty-four (13%) out of 183 cases of SAP had hemorrhagic complications-12 intraabdominal & 12 intraluminal, 13 had major & 11 had minor and 16 had de-novo & 8 post-surgical bleeding. The mean duration of pancreatitis prior to bleeding was 27±27.2 days. Results: Predictors of haemorrhage on univariate analysis were delayed admission (0.037), more than one organ failure (p=0.008), presence of venous thrombosis (p=0.033), infective necrosis (0.001) and systemic sepsisbacterial (0.037) & fungal (p=0.032). On multivariate analysis infected necrosis (OR=11.82) and presence of fungal sepsis (OR=3.73) were the significant factors. Patients presenting with more than one organ failure and bacterial sepsis had borderline significance on multivariate analysis. Need for surgery (50% vs. 12.6%), intensive care stay (7.4±7.9 vs. 5.4±5.2 days) and mortality (41.7% vs. 10.7%) were significantly higher in patients who suffered haemorrhage. Seven of the 13 with major bleeding had pseudoaneurysms-4 were embolized, 4 needed surgery including 1 embolization failure. Seven with intraabdominal bleeding required surgical intervention, 2 had successful embolization and 3 had expectant management. CT severity index and surgical intervention, were significantly associated with intraabdominal bleeding. Organ failure, presence of pseudoaneurysm and surgical intervention were associated with major bleeding. Conclusions: Hemorrhage in SAP was associated with increased morbidity and mortality. Infected necrosis accentuated the degradation of the vessel wall, which predispose to hemorrhage. Luminal bleeding may be indicative of erosion into the adjacent viscera by the pseudoaneurysm.

show abstract

A case of upper gastrointestinal bleeding due to pancreatic pseudoaneurysm rupture

Siew,

Yeh

2024

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

Treatment strategies for bleeding from gastroduodenal artery pseudoaneurysms complicating the course of chronic pancreatitis—A case series of 10 patients

Cited by 14 publications

References 32 publications

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

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

Hemorrhage complicating the course of severe acute pancreatitis

A case of upper gastrointestinal bleeding due to pancreatic pseudoaneurysm rupture

Contact Info

Product

Resources

About