title: Angiographic embolization is an effective treatment of severe hemorrhage in pancreatitis.
abstract: OBJECTIVE
  The aim of this study was to analyze the role of radiologic embolization as a diagnostic and therapeutic modality for severe hemorrhage in pancreatitis.
  
  
  METHODS
  All patients with pancreatitis who underwent mesenteric angiography for a 3-year period were identified and analyzed retrospectively.
  
  
  RESULTS
  Nine separate bleeding episodes were treated with embolization (mean age, 56 years). This consisted of 6 patients who underwent primary angiographic embolization, with 3 patients requiring further embolization because of repeated bleeding from a different site. Most patients (83%) had chronic disease. The causative arteries were identified as splenic (6/9 patients), gastroduodenal (1/9 patients), left gastric (1/9 patients), and a small branch of the inferior mesenteric (1/9 patients). Clinical presentations were abdominal pain (3/9 patients), melena (3/9 patients), bleeding into retroperitoneal drain (2/9 patients), and hematemesis (1/9 patients). Bleeding was severe with an average drop in hemoglobin level of 6.3 g/dL. Of the 3 patients who required further embolization, all had splenic artery pseudoaneurysms and 2 patients experienced chronic pancreatitis with necrosis and proven peripancreatic infections. In all cases (9/9 patients), angiography succeeded in identifying and embolizing the causative vessel with a 1-year mortality of 0%.
  
  
  CONCLUSIONS
  Angiographic embolization is an effective treatment of the life-threatening bleeding that occurs secondary to pancreatitis.
authors.affiliation: From the Departments of *Surgery, and †Radiology, Ninewells Hospital, Dundee, Scotland, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Fitzpatrick
authors.forename: Raj
authors.initials: R
authors.lastname: Bhat
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D050500:Pancreatitis, Chronic / Q000150:complications; D012189:Retrospective Studies; D013157:Splenic Artery / Q000000981:diagnostic imaging*; D016896:Treatment Outcome