Visceral artery pseudoaneurysm in necrotizing pancreatitis: incidence and outcomes

Maatman, Thomas K.; Heimberger, Mark A.; Lewellen, Kyle A.; Roch, Alexandra M.; Colgate, Cameron L.; House, Michael G.; Nakeeb, Attila; Ceppa, Eugene P.; Schmidt, C. Max; Zyromski, Nicholas J.

doi:10.1503/cjs.009519

Cited by 33 publications

(29 citation statements)

References 38 publications

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“…An arterial pseudoaneurysm is a ruptured vessel with a surrounding hematoma in communication with the vessel lumen. It is the result of injury to the vessel from surrounding inflammation and pancreatic enzymes [ 5 ]. Endovascular intervention for pseudoaneurysms is reportedly equally effective to surgery because of its 79%-100% efficacy [ 6 ], but rebleeding can still occur.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Acute Pancreatitis Complicated With Pseudoaneurysms and Venous Thrombosis

Wada¹,

Matsumoto²,

Sai³

et al. 2023

Cureus

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Vascular complications, such as pseudoaneurysms and thrombosis, are uncommon in pediatric acute pancreatitis (AP); hence, treatment experience remains limited. Here, we report a case of adolescent AP complicated with pseudoaneurysms and venous thrombosis simultaneously. Even after multiple endovascular embolizations for pseudoaneurysms, the patient experienced hemorrhagic shock resulting from pseudoaneurysm rupture after taking anticoagulants for thrombus. Inevitably, a total pancreatectomy was performed to prevent bleeding and control local complications. In AP, even among the pediatric population, a therapeutic dilemma between bleeding prevention and anticoagulation for thrombosis may occur. Despite the lack of experience with AP and its complications, a total pancreatectomy may become an alternative therapy for refractory AP or its complications.

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Section: Discussionmentioning

confidence: 99%

Adolescent Acute Pancreatitis Complicated With Pseudoaneurysms and Venous Thrombosis

Wada¹,

Matsumoto²,

Sai³

et al. 2023

Cureus

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“…El interés de este caso radica en lo infrecuente de las complicaciones vasculares arteriales y sobre todo en las que afectan a vasos de pequeño calibre 1 , en la dificultad diagnóstica al solaparse en el tiempo dos patologías completamente independientes entre sí, así como en la distancia presente entre pseudoaneurisma y colección, dado que habitualmente aparecen en contigüidad por disección de la pared vascular 4 . Esto podría venir justificado por la formación de dicha colección en relación no al episodio actual de pancreatitis, sino al acontecido un año antes.…”

Section: Discussionunclassified

Challenging acute gastrointestinal bleeding

Jiménez

Carrasco

2021

RAPDOnline

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Resumen Se presenta el caso de un varón de 57 años con antecedentes de un episodio de pancreatitis aguda un año antes, que ingresa por un nuevo episodio de pancreatitis complicado con un sangrado digestivo inicialmente atribuido al diagnóstico concurrente de un adenocarcinoma sobre esófago de Barret, que actuó realmente como elemento distractor en el diagnóstico de la rotura del pseudoaneurisma visceral arterial, que constituía la verdadera causa de sangrado.

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“…The exposure of visceral arteries to the enzymes may cause autodigestion of the wall leading to necrotizing arteritis, resulting in the weakening of the vessel lumen, causing a PSA formation. They are usually associated with a preexisting pseudocyst but can also occur without a pseudocyst[ 5 , 6 ].…”

Section: Pseudoaneurysmmentioning

confidence: 99%

“…The true incidence is unknown, but it ranges from 4% to 17% in single-center reports, with a higher incidence in males[ 7 - 9 ]. PSA is reported mostly in alcohol-induced pancreatitis, but the etiologic factor is not exclusive, and pediatric/hereditary pancreatitis cases have also been reported[ 5 , 8 ]. Patients present with abdominal pain or gastrointestinal bleeding secondary to rupture.…”

Section: Pseudoaneurysmmentioning

confidence: 99%

Vascular complications of pancreatitis

Kalas¹,

León²,

Chavez³

et al. 2022

WJCC

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More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America. Necrotizing pancreatitis accounts for 20%-30% of the cases. One-quarter of the patients with pancreatitis develop vascular complications, which carries a high mortality. This mini-review will address these complications that can help primary care physicians and hospitalists in managing their patients effectively.

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Visceral artery pseudoaneurysm in necrotizing pancreatitis: incidence and outcomes

Abstract: Background: Visceral artery pseudoaneurysms (VA-PSA) occur in necrotizing pancreatitis; however, little is known about their natural history. This study sought to evaluate the incidence and outcomes of VA-PSA in a large cohort of patients with necrotizing pancreatitis.

Cited by 33 publications

References 38 publications

Adolescent Acute Pancreatitis Complicated With Pseudoaneurysms and Venous Thrombosis

Adolescent Acute Pancreatitis Complicated With Pseudoaneurysms and Venous Thrombosis

Challenging acute gastrointestinal bleeding

Vascular complications of pancreatitis

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