Pseudoaneurysm associated haemosuccus pancreaticus - a rare and dangerous disease

CVIR Endovascular
Julia WagenpfeilCarsten Meyer

Abstract

In patients with upper gastrointestinal bleeding and hemorrhage originating from the major duodenal papilla pseudoaneurysm associated haemosuccus pancreaticus (HP) is a rare differential diagnosis which should be considered. Diagnosis may be challenging, as clinical presentation is often unspecific with only intermittent hemorrhage. Treatment of the causal pseudoaneurysm is mandatory and endovascular coil embolization is the suitable first-line management strategy. Until now there are only a very few studies about this clinical picture and its therapeutic options, especially data regarding whether additional fluid embolization is beneficial/necessary in HP is currently lacking. We report a case of a 59-year-old male patient with chronic pancreatitis and haemosuccus pancreaticus caused by a pancreatico-arterial fistula with an associated inflammatory pseudoaneurysm of the splenic artery. Initially we sought to embolize the pseudoaneurysm with microcoils. As only one coil could be safely deployed in the pseudoaneurysm we additionally employed tissue adhesive embolization in order to achieve complete occlusion of the pseudoaneurysm as well as the pancretico-arterial fistula. In the presented case inflammatory levels decreased foll...Continue Reading

References

Sep 1, 2009·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Velayutham VimalrajRajagopal Surendran
Oct 30, 2016·BMJ Case Reports·Prateush SinghJavaid Subhani

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