Endovascular treatment of pseudoaneurysms secondary to chronic pancreatitis: reports of two cases

Abstract Pseudoaneurysm secondary to chronic pancreatitis is a rare complication, but one with a high mortality rate. It is etiologically associated with chronic pancreatitis, and most diagnoses are made after rupture, which manifests with clinical signs of acute hemorrhage. Computed tomography play...

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Bibliographic Details
Published in:Jornal vascular brasileiro 2018-01, Vol.17 (1), p.71-75
Main Authors: Santos, Fabiana Seifert, Sousa, Karolaine Marcelina da Silva, Castro, Thiago Augusto Cadorin de, Coelho Neto, Felipe, Oliveira, Rodrigo Gomes de, Araujo, Walter Jr. Boim de, Santos, Lilian Cabral Pereira dos, Souza, Raquel Canzi Almada de
Format: Article
Language:English
Subjects:
alcoholic pancreatitis
arteriography
CARDIAC & CARDIOVASCULAR SYSTEMS
Case Report
chronic pancreatitis
endovascular surgery
PERIPHERAL VASCULAR DISEASE
pseudoaneurysm of the splenic artery
SURGERY
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Summary:Abstract Pseudoaneurysm secondary to chronic pancreatitis is a rare complication, but one with a high mortality rate. It is etiologically associated with chronic pancreatitis, and most diagnoses are made after rupture, which manifests with clinical signs of acute hemorrhage. Computed tomography plays an important role in diagnosis, but digital subtraction angiography remains the gold-standard method for diagnostic confirmation and for treatment planning. This article describes two cases of pseudoaneurysm in patients with chronic alcoholic pancreatitis; one involving the splenic artery and the other the gastroduodenal artery, complicated by thoracic and abdominal bleeding respectively. Both were successfully treated, using minimally invasive endovascular methods to implant coils and stent-grafts. Resumo O pseudoaneurisma decorrente de pancreatite crônica consiste em complicação rara, porém com alta taxa de mortalidade. Está etiologicamente associado à pancreatite crônica, e seu diagnóstico é feito mais comumente após ruptura, manifestando-se através de sinais clínicos de hemorragia aguda. A tomografia computadorizada desempenha papel importante no diagnóstico; contudo, a angiografia por subtração digital mantém-se como método padrão-ouro para confirmação diagnóstica e direcionamento do tratamento. O presente artigo relata dois casos de pseudoaneurisma em pacientes com pancreatite crônica alcoólica, sendo um da artéria esplênica e outro da artéria gastroduodenal, complicados com sangramento torácico e abdominal respectivamente. Ambos foram submetidos a tratamento endovascular minimamente invasivo com sucesso, através de implante de molas e de stent-grafts.
ISSN:1677-5449
1677-7301
1677-7301
DOI:10.1590/1677-5449.012517