Unusual complication of chronic pancreatitis

Česká verzia

Authors: A. Houska ¹; F. Závada ¹; J. Lacman ²; I. Buřič ²; J. Csomor ¹; M. Zavoral ¹; P. Frič ¹
Authors place of work: Interní klinika, 1. LF UK a ÚVN Praha2Radiodiagnostické oddělení, ÚVN Praha ¹
Published in the journal: Gastroent Hepatol 2011; 65(3): 154-156
Category: Klinická a experimentální gastroenterologie: kazuistika

Summary

A 52-year-old man with a ten-year history of chronic calcifying pancreatitis of toxo-metabolic etiology was admitted to hospital with an acute exacerbation of chronic pancreatitis. On the day 4 of hospitalization his clinical status was complicated by retroperitoneal bleeding due to the rupture of a splenic artery pseudoaneurysm. The vascular defect was treated by endovascular embolization without need for surgical intervention. Rupture of the splenic artery pseudoaneurysm is a rare but serious complication of chronic pancreatitis with a high mortality rate. As the incidence of this complication is low, there are no specific guidelines for immediate treatment. Endovascular intervention is the first of treatment of choice for hemodynamically stable patients. Its success rate is high; however, so is the risk of re-bleeding. Surgical intervention is indicated in hemodynamically unstable patients after the failure of an endovascular intervention, or in the event of re-bleeding. The extent of surgery depends on the locality of the lesion and on the primary pancreatic affection.

Key words:
chronic pancreatitis – retroperitoneal bleeding – splenic artery pseudoaneurysm – endovascular intervention

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