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Large Intestine Bleeding Caused by the Lienal Artery Pseudoaneurysm Rupture Complicating a Pancreatic Pseudocyst


Authors: M. Kalavský 1;  J. Smetka 2
Authors‘ workplace: Chirurgické oddělení, Nemocnice Kyjov, MUDr. B. Okénka – pověřen vedením 1;  1. chirurgická klinika, FN u sv. Anny Brno, přednosta: prof. MUDr. Ivan Čapov, CSc. 2
Published in: Rozhl. Chir., 2011, roč. 90, č. 10, s. 590-593.
Category: Monothematic special - Original

Overview

Bleeding pseudoaneurysm of a peripancreatic artery is a rare cause of gastrointestinal haemorrhage. Arterial pseudoaneurysm develops as a result of partial enzymatic damage of arterial wall in acute or chronic pancreatitis. The authors report the case of a 60-years old man with bleeding into the lienal flexure of the colon due to the erosion of the pseudoaneurysm of a branch of splenic artery into the pancreatic pseudocyst in the tail region of the pancreas communicating with the colon. The diagnosis was established by CT-scan and angiography. The patient underwent surgery with the ligation of the bleeding vessel and the resection of the part of the colon.

Key words:
gastrointestinal haemorrhage – chronic pancreatitis – pancreatis pseudocyst – peripancreatic pseudoaneurysm


Sources

1. Eckhauser, F. E., Stanley, J. C., Zelenock, G. B., et al. Gastroduodenal and pancreaticoduodenal artery aneurysms: a complication of pancreatitis causing spontaneous gastrointestinal hemorrhage. Surgery, 1980; 88: 335–344.

2. Watanabe, M., Nakazaki, H., Tokura, N., et al. Intraoperative packing of pancreatic pseudocyst complicated with bleeding pseudoaneurysm. J. Hepatobiliary Pancreat. Surg., 2004; 11: 422–425.

3. el Hamel, A., Parc, R., Adda, G., et al. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis. Br. J. Surg., 1991; 78: 1059–1063.

4. Freedman, S. D. Complication of chronic pancreatitis. Up To Date [on line]. Wellesley, 2005, vol 13.3. Dostupný na WWW: http://www.uptodate.com

5. Kiviluoto, T., Schroder, T., Kivilaakso, E., et al. Acute haemorrhage associated with pancreatic pseudocyst and chronic pancreatitis. Ann. Chir. Gynaecol., 1984; 73: 214–218.

6. Pitkaranta, P., Haapiainen, R., Kivisaari, L., et al. Diagnostic evaluation and aggressive surgical approach in bleeding pseudoaneurysms associated with pancreatic pseudocysts. Scand. J. Gastroenterol., 1991; 26: 58–64.

7. Bureš, J. Haemosuccus pancreaticus. How difficult is the diagnosis and how dangerous is the status? Folia Gastroenterol. Hepatol., 2005; 3: 144–149.

8. Sandblom, P. Gastrointestinalhemorrhage through the pancreatic duct. Ann. Surg., 1970; 171: 61–66.

9. Suter, M., Doenez, F., Chapuis, G., et al. Hemorrhage into the pancreatic duct (Hemosuccus pancreaticus). Recognition and management. Eur. J. Surg., 1995; 161: 887–892.

10. Elton, E., Howell, D. A., Amberson, S. M., et al. Combined angiographic and endoscopic management of bleeding pancreatic pseudoaneurysms. Gastrointest. Endosc., 1997; 46: 544–549.

11. Frič, P. Komplikace. In: Dítě, P., et al.: Chronická pankreatitida. Praha, Galén, 2002: 217–223.

12. Hledík, E., Šonský, E., Sobotovičová, A., et al. Krvácení do trávicí trubice při tryptické lézi tračníku. Čes. Radiol., 2002; 56(1): 48–50.

13. Udd, M., Leppäniemi, A. K., Bidel S., et al. Treatment of Bleeding Pseudoaneurysms in Patients with Chronic Pancreatitis. World J. Surg., 2007; 31: 504–510.

14. Kaman, L., Sanyal, S., Menakuru, R., et al. Pseudoaneurysm of the Superior Pancreaticoduodenal Artery, a Rare Cause of Hemosuccus Pancreaticus: Report of a Case. Surg. Today, 2004; 34: 181–184.

15. Camishon, R. C., Pello, M. J., Spence, R. K., et al. Hemoductal pancreatitis. Surgery, 1990; 111: 86–89.

16. Panackel, C., Kumar, N., Subhalal, N., et al. Hepatobiliary and pancreatic: Hemosuccus pancreaticus complicating calcific chronic pancreatitis. Journal of Gastroenterology and Hepatology, 2007; 22: 1691.

17. Al-Tashi, M., Krajina, A., Sobotka, L., et al. Massive gastric bleeding from pseudoaneurysm of the arteria lienalis as a serious complication of pancreatic pseudocyst perforating to the stomach. Folia Gastroenterol. Hepatol., 2005; 3 (4): 144–149.

18. Gambiez, L. P., Ernst, O. J., Merlier, O. A., et al. Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Arch. Surg., 1997; 132: 1016–1021.

19. Sand, J. A., Seppanen, S. K., Nordback, I. H. Intracystic hemorrhage in pancreatic pseudocysts: initial experiences of a treatment protocol. Pancreas, 1997; 14: 187–191.

20. Forsmark, C. E. Chronic pancreatitis. In: Feldman, M., Friedman, L. S., Sleisenger, M. H.: Sleisenger and Fordtranęs Gastrointestinal and Liver Disease. 7th ed. Philadelphia, Saunders, 2002: 943–969.

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Surgery Orthopaedics Trauma surgery
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