Hemorrhagic pseudocyst and pseudocyst with pseudoaneurysm successfully treated by pancreatectomy: report of three cases |
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Authors: | Masatsugu T Yamaguchi K Yokohata K Mizumoto K Chijiiwa K Tanaka M |
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Institution: | (1) Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan, JP |
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Abstract: | Hemorrhagic pseudoaneurysm of pancreatic pseudocyst is one of the serious complications of acute pancreatitis. We successfully
treated three patients who had hemorrhagic pseudocyst and pseudocyst with pseudoaneurysm by pancreatectomy. Case 1 was 43-year-old
Japanese man who had had several episodes of acute pancreatitis and was diagnosed with hemorrhagic pseudoaneurysm of the splenic
artery in a pseudocyst in the pancreatic tail, shown on computed tomography (CT) and angiography. Transarterial embolization
(TAE) yielded hemostasis of the pseudoaneurysm, but rebleeding occurred 2 weeks after the TAE. Distal pancreatectomy and splenectomy
was successfully performed. Case 2 was a 64-year-old Japanese man who presented to us with several attacks of acute pancreatitis.
Imagings showed bleeding pseudoaneurysm of the transverse pancreatic artery in a pseudocyst in the pancreatic body. Because
of marked stenosis in the proximal portion of the transverse pancreatic artery, TAE was unsuccessful. Distal pancreatectomy
and splenectomy was performed successfully. Case 3 was a 40-year-old Japanese woman who had a history of abdominal trauma.
Imagings showed bleeding pseudoaneurysm of the splenic artery in a posttraumatic pseudocyst in the pancreas. TAE of the pseudoaneurysm
was unsuccessful because of the proximity of the pseudoaneurysm and the splenic artery. Distal pancreatectomy and splenectomy
was successfully performed and her postoperative outcome was satisfactory. Whenever interventional radiology (IVR) is not
indicated or has failed, aggressive and immediate surgical intervention should be considered for early and definitive recovery
in these patients.
Received: November 15, 1999 / Accepted: April 6, 2000 |
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Keywords: | Pseudocyst Hemorrhage Interventional radiology |
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