Control of major haemorrhage associated with pancreatic pseudocysts by transcatheter arterial embolization

Massive haemorrhage from a pancreatic pseudocyst is an uncommon cause of upper gastrointestinal bleeding. The condition carries a high mortality and presents a major clinical problem both in terms of timely diagnosis and appropriate surgical therapy. Four patients are presented with pseudocyst‐related bleeding arising from the gastroduodenal artery. In all instances the bleeding was successfully controlled by transcatheter embolization with gelfoam. No untoward sequelae were noted and the occlusion remained effective as shown by follow‐up angiography 2 months later. The importance of early diagnostic angiography is stressed and it is concluded that interventional angiography may obviate the need for high risk emergency surgery.

[1]  C. Venables,et al.  Chronic pancreatitis as a cause of gastrointestinal bleeding. , 1982, Gut.

[2]  Anderson Mc,et al.  Hemorrhagic complications of severe pancreatitis. , 1981 .

[3]  L. Brandt,et al.  Duodenal infarction after therapeutic gelfoam embolization of a bleeding duodenal ulcer , 1981 .

[4]  J. Stanley,et al.  Gastroduodenal and pancreaticoduodenal artery aneurysms: a complication of pancreatitis causing spontaneous gastrointestinal hemorrhage. , 1980, Surgery.

[5]  H. P. Jander,et al.  Transcatheter gelfoam embolization in abdominal, retroperitoneal, and pelvic hemorrhage. , 1980, Radiology.

[6]  C. F. Beckmann,et al.  Experimental determination of flow patterns of gelfoam emboli: safety implications. , 1980, AJR. American journal of roentgenology.

[7]  J. Trojanowski,et al.  Hepatic and splenic infarctions: complications of therapeutic transcatheter embolization. , 1980, American journal of surgery.

[8]  D. Trunkey,et al.  Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. , 1978, Archives of surgery.

[9]  B. Bivins,et al.  Hemosuccus pancreaticus (hemoductal pancreatitis): gastrointestinal hemorrhage due to rupture of a splenic artery aneurysm into the pancreatic duct. , 1978, Archives of surgery.

[10]  G. Simonetti,et al.  Transcatheter therapeutic arterial embolization. , 1976, Radiology.

[11]  M. Bernardino,et al.  High dose urography: incidence and relationship to spontaneous peripelvic extravasation. , 1976, AJR. American journal of roentgenology.

[12]  S. Baum,et al.  Aneurysms secondary to pancreatitis. , 1976, AJR. American journal of roentgenology.

[13]  Timothy A. Miller,et al.  Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis. , 1976, Archives of surgery.

[14]  J. Rösch,et al.  Selective arterial embolization. A new method for control of acute gastrointestinal bleeding. , 1972, Radiology.

[15]  J. Trapnell Management of the complications of acute pancreatitis. , 1971, Annals of the Royal College of Surgeons of England.

[16]  O. Quintero,et al.  False Aneurysm in a Pancreatic Pseudocyst , 1970, Annals of surgery.

[17]  I. Marks,et al.  Peptic ulceration and gastrointestinal bleeding in pancreatitis. , 1967, Gut.