| Pancreatic pseudoaneurysm of the superior mesenteric artery complicated with obstructive jaundice. A case report. | |
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MedLine Citation:
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PMID: 15650282 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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CONTEXT: Pancreatic pseudoaneurysm rupture is a rare complication of chronic pancreatitis, with severe prognosis and high mortality. Angiography is usually required for confirmation of the diagnosis, but transabdominal ultrasound and CT angiography are useful noninvasive diagnostic methods. CASE REPORT: We present the case of a 66-year-old patient with a large pancreatic pseudoaneurysm of the superior mesenteric artery complicated with obstructive jaundice. Transabdominal ultrasound with color and power Doppler showed a large pancreatic head pseudoaneurysm that communicated directly to the superior mesenteric artery. Presence of a spinning blood flow inside the pseudoaneurysm was visualized by color Doppler, with evidence of bidirectional flow in the pseudoaneurysm neck that was showed by Doppler spectral analysis. The contrast-enhanced helical computer tomography with multiplanar sagittal and the 3D reconstruction of coronal images confirmed the communication of the pseudoaneurysm with the superior mesenteric artery. The patient was scheduled for selective angiography and embolization. However, clinical evolution was rapidly deteriorating, with collapse, hemorrhagic shock and massive hemorrhage. The patient was operated on and subsequently died despite three days of intensive care, due to disseminated intravascular coagulation and multiorgan failure. CONCLUSION: Non invasive imaging methods consisting of transabdominal ultrasound with color Doppler and contrast-enhanced computer tomography with sagittal reconstruction of coronal images were very useful in the establishment of the diagnosis of pancreatic pseudoaneurysm of the superior mesenteric artery complicated with cholestatic jaundice. However, these imaging methods do not obviate the need for diagnostic and therapeutic angiography, eventually followed by surgical intervention in cases of recurrent bleeding or hemodynamic unstable patients. |
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Authors:
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Adrian Saftoiu; Sevastita Iordache; Tudorel Ciurea; Daniela Dumitrescu; Mihai Popescu; Zoia Stoica |
Publication Detail:
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Type: Case Reports; Journal Article; Review Date: 2005-01-13 |
Journal Detail:
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Title: JOP : Journal of the pancreas Volume: 6 ISSN: 1590-8577 ISO Abbreviation: JOP Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-01-14 Completed Date: 2006-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101091810 Medline TA: JOP Country: Italy |
Other Details:
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Languages: eng Pagination: 29-35 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, University of Medicine and Pharmacy Craiova, Craiova, Dolj, România. adry@umfcv.ro <adry@umfcv.ro> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aneurysm, False / complications* Fatal Outcome Humans Jaundice, Obstructive / etiology* Male Mesenteric Artery, Superior* Pancreas / blood supply |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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