| Abstrakt: |
Pseudoaneurysms of the peripancreatic arteries are rare but very serious complications of chronic pancreatitis. The aim of this study was to investigate the diagnostic and treatment methods used on 6 patients with pseudoaneurysms of the peripancreatic arteries and chronic pancreatitis hospitalized in the Department of General, Gastroenterological Surgery and Nutrition of the Medical University of Warsaw. In this paper we analyze the symptoms, location, diagnostic methods, treatment and complications of pseudoaneurysms. Seven patients (5 F, 2 M) ranging in age from 37 to 70 years (median age, 53) were hospitalized due to abdominal pain (5 patients) and bleeding from the gastrointestinal tract (2 patients). Diagnostic procedures performed (CT, AngioCT, arteriography, Doppler USG) revealed the presence of pseudoaneurysms of the splenic artery in 3 patients, the gastroduodenal artery in 1 patient, the pancreaticoduodenal arteries in 2 patients and the left gastric artery in 1 patient. Four patients were treated primarily by intravascular embolization, which was successful in only 2 patients, although one of these patients had to be operated on because of an abscess in pseudoaneurysm cavity. All of the patients, except two (the first did not give the permission for surgery while the second had a pseudoaneurysm as a result of a thermoablation of a pancreatic tumor) were treated surgically. In each case a ligation of the artery was performed, together with a splenectomy in 2 patients. In 1 case a pancreaticoduodenectomy had to be performed. Among from the patients who underwent operation, postoperative complications occurred in 1 case, which was septic bleeding from the splenic artery. Pseudoaneurysms of the peripancreatic arteries are a difficult to diagnose complication of chronic pancreatitis. Treatment by use of intravascular embolization, which is recommended by most authors, was not very effective in our study. In 85% of our patients, successful treatment was achieved by use of surgical methods. [ABSTRACT FROM AUTHOR] |
