title: Case of a bleeding pseudoaneurysm of the middle colic artery complicating acute pancreatitis.
abstract: 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.
authors.affiliation: Department of Surgery, Simonoseki City Hospital, Simonoseki, Japan. toyon@med.kyusju-u.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Toyonaga
authors.forename: Sakae
authors.initials: S
authors.lastname: Nagaoka
authors.forename: Kennoki
authors.initials: K
authors.lastname: Ouchida
authors.forename: Morisuke
authors.initials: M
authors.lastname: Nagata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shirota
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ogawa
authors.forename: Junnichi
authors.initials: J
authors.lastname: Yoshida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sinohara
authors.forename: Kennichi
authors.initials: K
authors.lastname: Matuo
authors.forename: Kennzo
authors.initials: K
authors.lastname: Sumitomo
authors.forename: Motoichi
authors.initials: M
authors.lastname: Akao
mesh_terms: 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
chemical_list: D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; C032855:nafamostat