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.
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.
Miki
Soichiro
S
Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ward, Tokyo, 113-8655, Japan. smiki-tky@umin.ac.jp
Mori
Kensaku
K
Masanari
Shiigai
S
Furuta
Toshihiro
T
Saida
Tsukasa
T
Hiratsuka
Makiko
M
Tohno
Eriko
E
Minami
Manabu
M
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
D003287:Contrast Media; D002245:Carbon Dioxide; D007455:Iodine; D019786:Gadolinium DTPA