Gastrointestinal and intraperitoneal bleeding due to multiple pseudoaneurysms postpartial pancreatectomy: A case report and literature review

Autor: Tao Zhen, Dacheng Hu, Xiaoxi Fan, Heshan Zhou, Bing Yang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Radiology Case Reports, Vol 19, Iss 11, Pp 5071-5077 (2024)
Druh dokumentu: article
ISSN: 1930-0433
DOI: 10.1016/j.radcr.2024.07.181
Popis: Postoperative pancreatic fistula, a significant complication following pancreaticoduodenectomy, can lead to the development of pseudoaneurysms, which in turn can result in hemorrhagic and septic complications. Here, we present the case of a 67-year-old male patient diagnosed with pancreatic head carcinoma who underwent partial pancreatectomy. Ten days postsurgery, the patient experienced hemorrhagic shock due to intraperitoneal bleeding. Emergency exploratory laparotomy and implantation of a stent in the common hepatic artery successfully stopped the bleeding. However, the patient later developed gastrointestinal bleeding, and no apparent source was detected during endoscopic examination. Two complex transcatheter arterial embolization procedures were performed, successfully stopping the bleeding. It is crucial to consider pseudoaneurysm in cases of suspected biliary and pancreatic leakage. This case also underscores the importance of a thorough vascular assessment prior to placing a coated stent, to prevent postoperative obstruction of catheter access to the responsible vessel. Additionally, embolization via the external path of the stent proved feasible.
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