title: Hemosuccus pancreaticus in a patient with iodine allergy: successful diagnosis with magnetic resonance imaging and treatment with transarterial embolization using carbon dioxide as the contrast medium.
abstract: Hemosuccus pancreaticus (HP) is defined as gastrointestinal bleeding via the pancreatic duct and duodenal papilla. Since the bleeding is usually intermittent, it often remains undetected by endoscopy. Most cases are diagnosed by contrast-enhanced computed tomography (CT) or angiography, and the first-line treatment is transarterial embolization (TAE). However, in general, these modalities require a large amount of iodinated contrast medium. Here, we report the case of a 50-year-old female with HP due to chronic pancreatitis. Contrast-enhanced CT and ordinary angiography were contraindicated for her, as she was allergic to iodine. She was diagnosed with HP following gadolinium-enhanced magnetic resonance imaging and successfully treated by TAE of the splenic artery with metallic coils using carbon dioxide as the contrast medium.
authors.affiliation: Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ward, Tokyo, 113-8655, Japan. smiki-tky@umin.ac.jp
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miki
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
authors.forename: Shiigai
authors.initials: S
authors.lastname: Masanari
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Furuta
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Saida
authors.forename: Makiko
authors.initials: M
authors.lastname: Hiratsuka
authors.forename: Eriko
authors.initials: E
authors.lastname: Tohno
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
mesh_terms: D017541:Aneurysm, False / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D015901:Angiography, Digital Subtraction; D002245:Carbon Dioxide; D003287:Contrast Media; D004342:Drug Hypersensitivity / Q000276:immunology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007455:Iodine / Q000276:immunology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000150:complications*; D013157:Splenic Artery
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide; D007455:Iodine; D019786:Gadolinium DTPA