Document Detail

Successful treatment of pseudoaneurysms of celiac and superior mesenteric arteries by combined endovascular and surgical approach.
MedLine Citation:
PMID:  18670849     Owner:  NLM     Status:  MEDLINE    
Pseudoaneurysm after pancreas resection poses serious complications, including rupture and hemorrhage. Here we report a case of delayed massive hemorrhage from celiac and superior mesenteric arteries, which was successfully treated with a combined endovascular and surgical approach. The patient was a 52-year-old man who presented with pseudoaneurysms of the celiac and superior mesenteric arteries after distal pancreatectomy. Following the detection of sentinel bleeding from the abdominal drain, emergency angiography of the celiac and superior mesenteric arteries revealed stenosis of the celiac artery and pseudoaneurysms in the superior mesenteric artery. We occluded these lesions with a platinum coil, using an interventional radiological technique combined with bypass grafting between the abdominal aorta and the SMA, using the saphenous vein. However, re-bleeding into the abdominal cavity occurred from the proximal SMA pseudoaneurysm. We inserted an endoluminal stent-graft into the abdominal aorta and completed bypass grafting between the aorta and bilateral renal arteries. The hemorrhage ceased and the postoperative course was uneventful. The patient was discharged 34 days after the treatment (149 days after the initial operation). In conclusion, this combined endovascular and surgical approach is feasible and seems appropriate for pseudoaneurysms arising from proximal sites in visceral arteries.
Takuro Saito; Takao Tsuchiya; Akira Kenjo; Takashi Kimura; Yoshihiro Sato; Takaharu Saito; Takayuki Anazawa; Shinya Takase; Hirono Satokawa; Youichi Satoh; Hitoshi Yokoyama; Hiromasa Ohira; Tsuyoshi Rai; Mitsukazu Gotoh
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-08-01
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic surgery     Volume:  15     ISSN:  0944-1166     ISO Abbreviation:  J Hepatobiliary Pancreat Surg     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431940     Medline TA:  J Hepatobiliary Pancreat Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  444-8     Citation Subset:  IM    
First Department of Surgery, Faculty of Medicine, Fukushima Medical University, 1-Hikarigaoka, Fukushima 960-1295, Japan.
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MeSH Terms
Aneurysm, False / surgery*
Blood Vessel Prosthesis Implantation* / methods
Celiac Artery / radiography,  surgery*
Lymph Node Excision
Mesenteric Artery, Superior / radiography,  surgery*
Middle Aged
Pancreatectomy / adverse effects
Pancreatic Neoplasms / surgery
Radiology, Interventional

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