Outflow of N-butyl-2-cyanoacrylate into the Pancreatic Duct: Transcatheter Arterial Embolization for Hemosuccus Pancreaticus

A 54-year-old Japanese woman, hospitalized for recurrent chronic alcoholic pancreatitis, manifested bloody stools. An esophagogastroduodenoscopy revealed active bleeding from the papilla of Vater. Contrast-enhanced computed tomography (CECT) revealed a pseudoaneurysm in the pancreatic pseudocyst (he...

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Bibliographic Details
Published in:Interventional Radiology 2020, Vol.5(2), pp.85-88
Main Authors: Nakama, Rakuhei, Yagami, Toshiaki, Kono, Isao, Arakawa, Kazukiyo, Usui, Koki, Kato, Koki, Tanimura, Keiichi, Honda, Masanori
Format: Article
Language:English
Subjects:
Case Report
complication
hemosuccus pancreaticus
N-butyl-2-cyanoacrylate
transcatheter arterial embolization
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Summary:A 54-year-old Japanese woman, hospitalized for recurrent chronic alcoholic pancreatitis, manifested bloody stools. An esophagogastroduodenoscopy revealed active bleeding from the papilla of Vater. Contrast-enhanced computed tomography (CECT) revealed a pseudoaneurysm in the pancreatic pseudocyst (hemosuccus pancreaticus). Angiography demonstrated pseudoaneurysm of the dorsal pancreatic artery branch. We selected N-butyl-2-cyanoacrylate (NBCA) as an embolus material because of the existing coagulopathy and difficulty in selecting the arterial branch. The administered NBCA outflowed into the pancreatic duct over the pseudoaneurysm. However, transcatheter arterial embolization (TAE) was successful, and no complication or rebleeding was observed after TAE. CECT showed NBCA cast in the pancreatic duct; however, the chronic pancreatitis improved. NBCA may be used to regulate hemosuccus pancreaticus in emergency settings; however, interventional radiologists must carefully consider the complications caused by NBCA.
ISSN:2432-0935
2432-0935
DOI:10.22575/interventionalradiology.2020-0002