title: Endovascular treatment of acute pseudoaneurysm associated to pancreaticoduodenectomy.
abstract: The study aim is to confirm feasibility and usefulness of endovascular stent-graft placement for superior mesenteric artery acute bleeding in presence of local sepsis. A superior mesenteric artery resection concomitant to a pancreaticoduodenectomy for carcinoma of the pancreas was followed by a saphenous vein bypass. A pancreatic leak associated to infection developed early in the postoperative course. Three weeks later, a massive haemorrhage due to rupture of an acute pseudoaneurysm was successfully treated with an endoluminal covered stent. This occluded two weeks later without important signs of bowel ischemia. The covered-stent placement allowed obtaining primary hemostasis and bowel perfusion preservation in spite of early occlusion. The patient did well after chemotherapy for one year and presented local recurrence at 16 months. Endovascular treatment of acute haemorrhage in presence of an intra-abdominal sepsis is feasible and useful following pancreatic surgery.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, Padua University, Italy. mauro.frego@unipd.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Frego
authors.forename: Matteo
authors.initials: M
authors.lastname: Bertin
authors.forename: Alberto
authors.initials: A
authors.lastname: Brolese
authors.forename: Roberto
authors.initials: R
authors.lastname: Ragazzi
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.forename: Davide F
authors.initials: DF
authors.lastname: D'Amico
mesh_terms: D000208:Acute Disease; D017541:Aneurysm, False / Q000628:therapy*; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D015607:Stents