Skip to main content
Top
Published in: CardioVascular and Interventional Radiology 6/2007

01-11-2007 | Case Report

Embolization Coils Migrating and Being Passed per Rectum After Embolization of a Splenic Artery Pseudoaneurysm, “The Migrating Coil”: A Case Report

Authors: Numan A. Shah, Akinfemi Akingboye, Nandon Haldipur, James Y. Mackinlay, George Jacob

Published in: CardioVascular and Interventional Radiology | Issue 6/2007

Login to get access

Abstract

Acute or chronic blood loss from pseudoaneurysms of the splanchnic artery in chronic pancreatitis poses diagnostic and management challenges. Arteriographic examination offers both diagnostic and therapeutic options, with success rates of 76%–100% for both modalities. In cases of failure of embolization, repeat embolization is also an option. Surgical intervention is advocated for rebleeding and failure of embolization. Evidence-based guidelines regarding the optimal treatment modality for this condition are lacking. There has been a reported case of dislodgement of coil into the stomach through a gastropseudocystic fistula. We report the case of a migrating steel-wire coil through the gastrointestinal tract and splenic artery pseudoaneurysm. We highlight the potential complications of pseudoaneurysm and other available therapeutic management options.
Literature
1.
go back to reference Gambiez LP, Ernst OJ, Melier OA, et al. (1997) Arterial embolization for bleeding pseudocyts complicating chronic pancreatitis. Arch Surg 132:1016–1021PubMed Gambiez LP, Ernst OJ, Melier OA, et al. (1997) Arterial embolization for bleeding pseudocyts complicating chronic pancreatitis. Arch Surg 132:1016–1021PubMed
2.
go back to reference Beattie GC, Hardman JG, Redhead D, et al. (2003) Evidence for a central role for selective mesenteric angiography in the management of major vascular complications of pancreatitis. Am J Surg 185:96–102PubMedCrossRef Beattie GC, Hardman JG, Redhead D, et al. (2003) Evidence for a central role for selective mesenteric angiography in the management of major vascular complications of pancreatitis. Am J Surg 185:96–102PubMedCrossRef
3.
go back to reference Takahashi T, Shimada K, Kobayashi N, et al. (2001) Migration of steel-wire coils into the stomach after transcatheter arterial embolization for a bleeding splenic artery pseudoaneurysm: report of a case. Surg Today 31(5):458–462PubMedCrossRef Takahashi T, Shimada K, Kobayashi N, et al. (2001) Migration of steel-wire coils into the stomach after transcatheter arterial embolization for a bleeding splenic artery pseudoaneurysm: report of a case. Surg Today 31(5):458–462PubMedCrossRef
4.
go back to reference Tessier DJ, Stone WM, Fowl RJ, et al. (2003) Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg 38(5):969–974PubMedCrossRef Tessier DJ, Stone WM, Fowl RJ, et al. (2003) Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg 38(5):969–974PubMedCrossRef
5.
go back to reference Balachandra S ,Siriwardena AK (2005) Systemic appraisal of the management of the major vascular complications of pancreatitis. Am J Surg 190:489–495PubMedCrossRef Balachandra S ,Siriwardena AK (2005) Systemic appraisal of the management of the major vascular complications of pancreatitis. Am J Surg 190:489–495PubMedCrossRef
6.
go back to reference de-Perrot M, Berney T, Buhler L, et al. (1999) Management of bleeding pseudoaneurysms in patient with pancreatitis. Br J Surg 86(1):29–32PubMedCrossRef de-Perrot M, Berney T, Buhler L, et al. (1999) Management of bleeding pseudoaneurysms in patient with pancreatitis. Br J Surg 86(1):29–32PubMedCrossRef
7.
go back to reference Hsu J-T, Yeh C-N, Hung C-F, et al. (2006) Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol 6:3PubMedCrossRef Hsu J-T, Yeh C-N, Hung C-F, et al. (2006) Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol 6:3PubMedCrossRef
8.
go back to reference Reber PU, Patel AG, Baer HU, et al. (1999) Acute haemorrhage in chronic pancreatitis: diagnostic and treatment options including superselective microcoil embolization. Pancreas 18(4):399–402PubMedCrossRef Reber PU, Patel AG, Baer HU, et al. (1999) Acute haemorrhage in chronic pancreatitis: diagnostic and treatment options including superselective microcoil embolization. Pancreas 18(4):399–402PubMedCrossRef
9.
go back to reference Guillon R, Garcier JM, Abergel A, et al. (2003) Management of splenic artery aneurysms and false aneurysms with endovascular treatment in 12 patients. CardioVasc Interv Radiol 26(3):256–260CrossRef Guillon R, Garcier JM, Abergel A, et al. (2003) Management of splenic artery aneurysms and false aneurysms with endovascular treatment in 12 patients. CardioVasc Interv Radiol 26(3):256–260CrossRef
10.
go back to reference Brountzos EN, Cagenas K, Apostolopoulou SC, et al. (2003) Pancreatitis associated splenic artery pseudoaneurysm: endovascular treatment with self expandable stent graft. CardioVasc Interv Radiol 26(1):88–91CrossRef Brountzos EN, Cagenas K, Apostolopoulou SC, et al. (2003) Pancreatitis associated splenic artery pseudoaneurysm: endovascular treatment with self expandable stent graft. CardioVasc Interv Radiol 26(1):88–91CrossRef
11.
go back to reference Guan-Yong S, Long S, Zhou-Xiang P, et al. (2005) Polyvinyl alcohol and gelatine sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis. World J Gastroenterol 11(17):2684–2686 Guan-Yong S, Long S, Zhou-Xiang P, et al. (2005) Polyvinyl alcohol and gelatine sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis. World J Gastroenterol 11(17):2684–2686
12.
go back to reference Bresler L, Boissel P, Grosdidier J (1991) Major hemorrhage from pseudoaneurysms caused chronic pancreatitis: surgical therapy. World J Surg 15:649–653PubMedCrossRef Bresler L, Boissel P, Grosdidier J (1991) Major hemorrhage from pseudoaneurysms caused chronic pancreatitis: surgical therapy. World J Surg 15:649–653PubMedCrossRef
13.
go back to reference Puri S, Nicholson AA, Breen DJ (2006) Percutaneous throbin injection for the treatment of a post-pancreatitis pseudoaneursym. Eur Radiol 13:79–82CrossRef Puri S, Nicholson AA, Breen DJ (2006) Percutaneous throbin injection for the treatment of a post-pancreatitis pseudoaneursym. Eur Radiol 13:79–82CrossRef
14.
go back to reference Iwama Y, Sugimoto K, Zamora CA, Yamaguchi M, Tsurusaki M, Taniguchi T, Mori T, Sugimura K (2006) Transcatheter embolization of splenic artery pseudo-aneurysm rupturing into colon after post-operative pancreatitis. CardioVasc Interv Radiol 29(1):133–136CrossRef Iwama Y, Sugimoto K, Zamora CA, Yamaguchi M, Tsurusaki M, Taniguchi T, Mori T, Sugimura K (2006) Transcatheter embolization of splenic artery pseudo-aneurysm rupturing into colon after post-operative pancreatitis. CardioVasc Interv Radiol 29(1):133–136CrossRef
Metadata
Title
Embolization Coils Migrating and Being Passed per Rectum After Embolization of a Splenic Artery Pseudoaneurysm, “The Migrating Coil”: A Case Report
Authors
Numan A. Shah
Akinfemi Akingboye
Nandon Haldipur
James Y. Mackinlay
George Jacob
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 6/2007
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-007-9166-7

Other articles of this Issue 6/2007

CardioVascular and Interventional Radiology 6/2007 Go to the issue