Document Detail


Hemosuccus pancreaticus associated with segmental arterial mediolysis successfully treated by transarterial embolization.
MedLine Citation:
PMID:  21068500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Hemosuccus pancreaticus, a rare cause of intermittent upper gastrointestinal bleeding, is usually caused by the rupture of an aneurysm associated with chronic pancreatitis. Segmental arterial mediolysis is a rare non-arteriosclerotic, non-inflammatory vascular disease characterized by vacuolization and lysis of the arterial smooth muscle cells. Segmental arterial mediolysis often causes intra-abdominal hemorrhage through aneurysm rupture. To our knowledge, hemosuccus pancreaticus associated with segmental arterial mediolysis has not previously been reported.
CASE REPORT: A 59-year-old man had suffered from recurrent episodes of epigastric pain and melena. Laboratory data showed mild anemia and an elevated serum amylase level. Upper gastrointestinal endoscopy revealed bloody pancreatic juice exuding from the papilla of Vater. There were no findings suggestive of chronic pancreatitis, such as pancreatic calcification, irregularity of the pancreatic duct and atrophy of the pancreas. Contrast-enhanced computed tomography revealed a large fusiform aneurysm of the middle-distal splenic artery, and dissection of the proximal splenic artery and celiac artery. Leakage of contrast medium from the aneurysm into the main pancreatic duct was also evident. Angiography clearly revealed a fusiform aneurysm of the splenic artery. This was managed successfully by transarterial coil embolization and the patient has subsequently shown no recurrence of epigastric pain or melena.
CONCLUSION: Segmental arterial mediolysis is a very rare cause of hemosuccus pancreaticus not associated with chronic pancreatitis. Transcatheter arterial embolization is useful for treatment of ruptured aneurysm associated with segmental arterial mediolysis.
Authors:
Itaru Naitoh; Tomoaki Ando; Masashi Shimohira; Takahiro Nakazawa; Kazuki Hayashi; Fumihiro Okumura; Katsuyuki Miyabe; Michihiro Yoshida; Hiroyuki Togawa; Shigeru Sasaki; Yuta Shibamoto; Takashi Joh
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-11-09
Journal Detail:
Title:  JOP : Journal of the pancreas     Volume:  11     ISSN:  1590-8577     ISO Abbreviation:  JOP     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-11     Completed Date:  2011-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101091810     Medline TA:  JOP     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  625-9     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Ruptured / complications,  diagnosis,  therapy
Celiac Artery / pathology
Embolization, Therapeutic / methods*
Hemorrhage / complications*,  diagnosis,  therapy*
Humans
Male
Mesenteric Arteries / pathology
Middle Aged
Pancreatic Diseases / complications*,  diagnosis,  therapy*
Tunica Media / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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