Open AccessEmbolisation of branches of the superior mesenteric artery in the treatment of haemosuccus pancreaticus
Author(s) -
Selma Regina de Oliveira Raymundo,
Gabriela Leopoldino da Silva,
Luiz Fernando Reis,
Antonio Fernandes Freire
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-229110
Subject(s) - medicine , pancreatitis , pseudoaneurysm , pancreatic duct , complication , surgery , gastrointestinal bleeding , aneurysm , radiology , superior mesenteric artery , pancreatic pseudocyst
Haemosuccus pancreaticus (HP) is an uncommon cause of upper gastrointestinal (GI) bleeding, most often intermittent, making it difficult to diagnose, becoming fatal. It usually occurs in patients with chronic pancreatitis and is caused by the rupture of a visceral aneurysm within the main pancreatic duct. The association between pseudoaneurysm formation and pancreatitis is well established. Pseudoaneurysm occurs in 3.5%-10% of pancreatitis cases and its rupture is a rare but life-threatening complication of chronic pancreatitis occurring in 6%-8% of patients with pseudocysts and corresponds to less than 1% of cases of GI bleeding.Its diagnosis is challenging, given the intermittent nature of bleeding. Angiographic therapy is considered the first-choice treatment, especially in patients who are stable haemodynamically. We present a case of embolisation of inferior pancreaticoduodenal branches with polyvinyl alcohol microparticles in the treatment of HP.