Case of a bleeding pseudoaneurysm of the middle colic artery complicating acute pancreatitis.
Massive bleeding from a pseudoaneurysm is rare, but it can be a life-threatening complication in patients with acute pancreatitis. We present a case in which massive bleeding from a pseudoneurysm in the middle colic artery complicating acute pancreatitis was successfully treated by transcatheter embolization and by continuous regional arterial infusion of a protease inhibitor and antibiotic. We also discuss the clinical features, diagnosis and treatment of such lesions in light of the literature. We emphasize the value of computed tomography in the early diagnosis of mesenteric hematoma in cases of acute pancreatitis and the value of angiography for control of bleeding from the complicating pseudoaneurysm.
Toyonaga
Takayuki
T
Department of Surgery, Simonoseki City Hospital, Simonoseki, Japan. toyon@med.kyusju-u.ac.jp
Nagaoka
Sakae
S
Ouchida
Kennoki
K
Nagata
Morisuke
M
Shirota
Toshihiko
T
Ogawa
Takahiro
T
Yoshida
Junnichi
J
Sinohara
Masahiro
M
Matuo
Kennichi
K
Sumitomo
Kennzo
K
Akao
Motoichi
M
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D000792:Angiography; D001158:Arteries; D001550:Benzamidines; D003106:Colon / Q000098:blood supply*; D004621:Embolization, Therapeutic; D006146:Guanidines / Q000008:administration & dosage; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007260:Infusion Pumps; D007261:Infusions, Intra-Arterial; D008297:Male; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D011480:Protease Inhibitors / Q000008:administration & dosage; D012187:Retroperitoneal Space; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; C032855:nafamostat