title: Pseudoaneurysm of the gastroduodenal artery following pancreatoduodenectomy. Stenting for hemorrhage.
abstract: Postpancreatectomy hemorrhage (PPH) and pancreatic fistula are main and serious complications following pancreaticoduodenectomy. Postpancreatectomy hemorrhage is considered life-threatening for its high rate of mortality. Postpancreatectomy hemorrhage is defined as early, occurring within 24 h after surgery, and late. The authors present a case of late PPH which developed in the third week following pylorus-preserving pancreaticoduodenectomy. A 58-year-old man was operated on for cancer of the pancreatic head. Hemorrhage occurred when the patient was in full health, convalescing at home. The cause was bleeding from a pseudoaneurysm of the stump of the gastroduodenal artery directly into the gastrointestinal tract. Diagnosis was established based on computed tomography angiography. Treatment was performed using minimally invasive technique during angiography. The implantation of a stent graft into the common hepatic artery for bridging the stump of the gastroduodenal artery was performed. This method thus enabled at once both diagnosis and successful minimally invasive treatment.
authors.affiliation: Department of Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Loveček
authors.affiliation: Department of Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Havlík
authors.affiliation: Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Köcher
authors.affiliation: Department of Surgery, University Hospital Olomouc, Czech Republic.
authors.forename: Katherine
authors.initials: K
authors.lastname: Vomáčková
authors.affiliation: Department of Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Cestmír
authors.initials: C
authors.lastname: Neoral
keywords: hemorrhage; pancreaticoduodenectomy; pseudoaneurysm; stents
references.citation: Arch Surg. 2008 Oct;143(10):1001-7; discussion 1007
references.pmid: 18936380
references.citation: J Vasc Surg. 2007 Feb;45(2):276-83; discussion 283
references.pmid: 17264002
references.citation: J Vasc Interv Radiol. 2011 Mar;22(3):294-301
references.pmid: 21353982
references.citation: Ann Surg. 2006 Dec;244(6):931-7; discussion 937-9
references.pmid: 17122618
references.citation: Surgery. 2012 Apr;151(4):612-20
references.pmid: 22088819
references.citation: World J Gastroenterol. 2010 Mar 14;16(10):1239-44
references.pmid: 20222168
references.citation: Wideochir Inne Tech Maloinwazyjne. 2013 Jun;8(2):117-29
references.pmid: 23837096
references.citation: J Gastrointest Surg. 2007 Apr;11(4):432-8
references.pmid: 17436126
references.citation: World J Gastroenterol. 2010 Aug 7;16(29):3716-22
references.pmid: 20677346
references.citation: Langenbecks Arch Surg. 2011 Aug;396(6):783-91
references.pmid: 21611815
references.citation: Surgery. 2007 Jul;142(1):20-5
references.pmid: 17629996