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| 篇名 |
Management of Bleeding Pseudoaneurysm with Arterial Embolization in ERCP-related Pancreatitis: Report of a Case |
| 作者 |
Jun-Te Hsu, Chih-Yuan Fu, Han-Ming Chen, Chien-Fu Hung,Tsann-Long Hwang, Yi-Yin Jan, Miin-Fu Chen |
| 卷期/出版年月 |
39卷2期 (2006/4) |
| 頁次 |
84-88 |
| 摘要 |
Peripancreatic pseudoaneurysms result either from enzymatic insult to pancreatic
and peripancreatic arteries or from erosion of a pseudocyst into adjacent visceral
arteries. A bleeding pseudoaneurysm is a rare complication of acute pancreatitis, and
management of bleeding pseudoaneurysms is still a challenge for clinicians because it
is associated with a high mortality rate. We here report on a 54-year-old male patient
suffering from acute pancreatitis related to endoscopic retrograde cholangiopancreatography.
He received aggressive medical treatment, since persistent fever and
abdominal pain were identified for 3 weeks. Laparotomy was performed under the
impression of pancreatic necrosis and abscess. During the operation, much fresh and
clotted blood was found to have accumulated in the right subphrenic space and
Morison's pouch. Active oozing and a circumferential seromuscular tear in the
second-portion of the duodenum were identified. The bleeding pseudoaneurysm was
identified postoperatively by means of angiography and was successfully treated with
arterial embolization. Pyloric exclusion and subsequent gastrojejunostomy were performed
to treat the duodenal injury. The patient was discharged home on the 33rd
day after the first surgery with no evidence of rebleeding or sequelae over the following
24 months. |
| 關鍵詞 |
bleeding pseudoaneurysm, embolization, endoscopic retrograde cholangiopancreatography,pancreatitis |
| 分類 |
Case Report |
|
