Skip to main content
Top
Published in: Emergency Radiology 1/2007

01-05-2007 | Case Report

Combined percutaneous thrombin injection and endovascular treatment of gastroduodenal artery pseudoaneurysm (PAGD): case report

Authors: Gianpaolo Carrafiello, Domenico Laganà, Chiara Recaldini, Monica Mangini, Domenico Lumia, Andrea Giorgianni, Anna Leonardi, Carlo Fugazzola

Published in: Emergency Radiology | Issue 1/2007

Login to get access

Abstract

A 69-year-old man with a history of acute pancreatitis developed a huge pseudoaneurysm of the gastroduodenal artery (PAGD), as diagnosed by CT scan. The PAGD was treated by percutaneous thrombin injection (2,000 IU) under ultrasound guidance and selective embolization of gastroduodenal artery with microcoils with its complete exclusion. The 6-month follow-up confirmed the complete exclusion of the PAGD sac.
Literature
1.
go back to reference Procacci C, Mansueto G, D’Onofrio M et al (2002) Non-traumatic abdominal emergencies: imaging and intervention in acute pancreatic conditions. Eur Radiol 12:2407–2434PubMed Procacci C, Mansueto G, D’Onofrio M et al (2002) Non-traumatic abdominal emergencies: imaging and intervention in acute pancreatic conditions. Eur Radiol 12:2407–2434PubMed
2.
go back to reference Stanley JC, Frey CF, Miller TA et al (1976) Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis. Arch Surg 111:435–440PubMed Stanley JC, Frey CF, Miller TA et al (1976) Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis. Arch Surg 111:435–440PubMed
3.
go back to reference Burke JW, Erickson SJ, Kellum CD et al (1986) Pseudoaneurysms complicating pancreatitis: detection by CT. Radiology 161:447–450PubMed Burke JW, Erickson SJ, Kellum CD et al (1986) Pseudoaneurysms complicating pancreatitis: detection by CT. Radiology 161:447–450PubMed
4.
go back to reference Levy P, Barthet M, Mollard BR et al (2006) Estimation of the prevalence and incidence of chronic pancreatitis and its complications. Gastroenterol Clin Biol 30:838–844PubMedCrossRef Levy P, Barthet M, Mollard BR et al (2006) Estimation of the prevalence and incidence of chronic pancreatitis and its complications. Gastroenterol Clin Biol 30:838–844PubMedCrossRef
5.
go back to reference Kiviluoto T, Kivisaari L, Kivilaakso E et al (1989) Pseudocysts in chronic pancreatitis. Surgical results in 102 consecutive patients. Arch Surg 124:240–243PubMed Kiviluoto T, Kivisaari L, Kivilaakso E et al (1989) Pseudocysts in chronic pancreatitis. Surgical results in 102 consecutive patients. Arch Surg 124:240–243PubMed
6.
go back to reference Sankaran S, Walt AJ (1975) The natural and unnatural history of pancreatic pseudocyst. Br J Surg 62:37–44PubMedCrossRef Sankaran S, Walt AJ (1975) The natural and unnatural history of pancreatic pseudocyst. Br J Surg 62:37–44PubMedCrossRef
7.
go back to reference Bresler L, Boissel P, Grosdidier J (1991) Major haemorrhage from pseudocysts and pseudoaneurysms caused by chronic pancreatitis: surgical therapy. World J Surg 15:649–653PubMedCrossRef Bresler L, Boissel P, Grosdidier J (1991) Major haemorrhage from pseudocysts and pseudoaneurysms caused by chronic pancreatitis: surgical therapy. World J Surg 15:649–653PubMedCrossRef
8.
go back to reference Hsu JT, Yeh CN, Hung CF et al (2006) Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol 6:3–8PubMedCrossRef Hsu JT, Yeh CN, Hung CF et al (2006) Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol 6:3–8PubMedCrossRef
9.
go back to reference Bergert H, Hinterseher I, Kersting S et al (2005) Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery 137:323–328PubMedCrossRef Bergert H, Hinterseher I, Kersting S et al (2005) Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery 137:323–328PubMedCrossRef
10.
go back to reference Delgadillo X, Berney T, Perrot M et al (1999) Successful treatment of a pseudoaneurysm of the cystic artery with microcoils embolization. J Vasc Interv Radiol 10:789–792PubMedCrossRef Delgadillo X, Berney T, Perrot M et al (1999) Successful treatment of a pseudoaneurysm of the cystic artery with microcoils embolization. J Vasc Interv Radiol 10:789–792PubMedCrossRef
11.
go back to reference Baker KS, Tisnado J, Cho SR et al (1987) Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization. Radiology 163:135–139PubMed Baker KS, Tisnado J, Cho SR et al (1987) Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization. Radiology 163:135–139PubMed
12.
go back to reference McDermott VG, Goldberg RS, Cope C (1994) Endovascular management of splenic artery aneurysms and pseudoaneurysms. Cardiovasc Interv Radiol 17:179–184CrossRef McDermott VG, Goldberg RS, Cope C (1994) Endovascular management of splenic artery aneurysms and pseudoaneurysms. Cardiovasc Interv Radiol 17:179–184CrossRef
13.
go back to reference Geokas MC (1968) The role of elastase in acute pancreatitis. Arch Pathol 86:135–141 Geokas MC (1968) The role of elastase in acute pancreatitis. Arch Pathol 86:135–141
14.
go back to reference Woods MS, Traverso LW, Kozarek RA et al (1995) Successful treatment of bleeding pseudoaneurysms of chronic pancreatitis. Pancreas 10:22PubMedCrossRef Woods MS, Traverso LW, Kozarek RA et al (1995) Successful treatment of bleeding pseudoaneurysms of chronic pancreatitis. Pancreas 10:22PubMedCrossRef
15.
go back to reference Reber PU, Baer HU, Patel AG (1998) Superselective microcoil embolization: treatment of choice in high-risk patients with extrahepatic pseudoaneurysms of the hepatic arteries. J Am Coll Surg 186:325–330PubMedCrossRef Reber PU, Baer HU, Patel AG (1998) Superselective microcoil embolization: treatment of choice in high-risk patients with extrahepatic pseudoaneurysms of the hepatic arteries. J Am Coll Surg 186:325–330PubMedCrossRef
16.
go back to reference Gambiez LP, Ernst OJ, Merlier OA et al (1997) Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Arch Surg 132:1016–1021PubMed Gambiez LP, Ernst OJ, Merlier OA et al (1997) Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Arch Surg 132:1016–1021PubMed
17.
go back to reference Yamakado K, Nakatsuka A, Tanaka N et al (2000) Transcatheter arterial embolization of ruptured pseudoaneurysms with coils and n-butyl cyanoacrylate. J Vasc Interv Radiol 11:66–72PubMed Yamakado K, Nakatsuka A, Tanaka N et al (2000) Transcatheter arterial embolization of ruptured pseudoaneurysms with coils and n-butyl cyanoacrylate. J Vasc Interv Radiol 11:66–72PubMed
18.
go back to reference Benjaminov O, Atri M (2002) Percutaneous thrombin injection for treatment of an intrarenal pseudoaneurysm. Am J Roentgenol 178:364–366 Benjaminov O, Atri M (2002) Percutaneous thrombin injection for treatment of an intrarenal pseudoaneurysm. Am J Roentgenol 178:364–366
19.
go back to reference Pezzullo JA, Dupuy DE, Cronan JJ (2000) Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression. Am J Roentgenol 175:1035–1040 Pezzullo JA, Dupuy DE, Cronan JJ (2000) Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression. Am J Roentgenol 175:1035–1040
20.
go back to reference Kang SS, Labropoulos N, Ashraf M et al (2000) Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms. J Vasc Surg 31:289–298PubMedCrossRef Kang SS, Labropoulos N, Ashraf M et al (2000) Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms. J Vasc Surg 31:289–298PubMedCrossRef
21.
go back to reference Reus M, Morales D, Vazquez V et al (2002) Ultrasound-guided percutaneous thrombin injection for treatment of extrarenal pseudoaneurysm after renal transplantation. Transplantation 74:882–884PubMedCrossRef Reus M, Morales D, Vazquez V et al (2002) Ultrasound-guided percutaneous thrombin injection for treatment of extrarenal pseudoaneurysm after renal transplantation. Transplantation 74:882–884PubMedCrossRef
22.
go back to reference Rothbarth LJ, Redmond PL, Kumpe DA (1989) Percutaneous transhepatic treatment of a large intrahepatic aneurysm. Am J Roentgenol 153:1077–1078 Rothbarth LJ, Redmond PL, Kumpe DA (1989) Percutaneous transhepatic treatment of a large intrahepatic aneurysm. Am J Roentgenol 153:1077–1078
23.
go back to reference Luchs SG, Antonacci VP, Reid SK et al (1999) Vascular and interventional case of the day: pancreatic head pseudoaneurysm treated with percutaneous thrombin injection. Am J Roentgenol 173:833–834 Luchs SG, Antonacci VP, Reid SK et al (1999) Vascular and interventional case of the day: pancreatic head pseudoaneurysm treated with percutaneous thrombin injection. Am J Roentgenol 173:833–834
24.
go back to reference Kemmeter P, Bonnell B, Vander Kolk W et al (2000) Percutaneous thrombin injection of splanchnic artery aneurysms: two case report. J Vasc Interv Radiol 11:469–472PubMed Kemmeter P, Bonnell B, Vander Kolk W et al (2000) Percutaneous thrombin injection of splanchnic artery aneurysms: two case report. J Vasc Interv Radiol 11:469–472PubMed
25.
go back to reference Puri S, Nicholson AA, Breen DJ (2003) Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm. Eur Radiol 13(Suppl 4):L79–L82PubMedCrossRef Puri S, Nicholson AA, Breen DJ (2003) Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm. Eur Radiol 13(Suppl 4):L79–L82PubMedCrossRef
26.
go back to reference Okazaky M, Ono H, Higashihara H et al (1991) Angiographic management of massive hemobilia due to iatrogenic trauma. Gastrointest Radiol 16:205–211CrossRef Okazaky M, Ono H, Higashihara H et al (1991) Angiographic management of massive hemobilia due to iatrogenic trauma. Gastrointest Radiol 16:205–211CrossRef
27.
go back to reference Manazer JR, Monzon JR, Dietz PA et al (2003) Treatment of pancreatic pseudoaneurysm with percutaneous trans-abdominal thrombin injection. J Vasc Surg 38:600–602PubMedCrossRef Manazer JR, Monzon JR, Dietz PA et al (2003) Treatment of pancreatic pseudoaneurysm with percutaneous trans-abdominal thrombin injection. J Vasc Surg 38:600–602PubMedCrossRef
28.
go back to reference Geoghegan T, Tuite D, Mc Auley G et al (2004) Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm of the gastroduodenal artery. Eur Radiol 14:2144–2145PubMedCrossRef Geoghegan T, Tuite D, Mc Auley G et al (2004) Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm of the gastroduodenal artery. Eur Radiol 14:2144–2145PubMedCrossRef
29.
go back to reference Sato N, Yamaguchi K, Shimizu S et al (1998) Coil embolization of bleeding visceral pseudoaneurysms following pancreatectomy: the importance of early angiography. Arch Surg 133:1099–1102PubMedCrossRef Sato N, Yamaguchi K, Shimizu S et al (1998) Coil embolization of bleeding visceral pseudoaneurysms following pancreatectomy: the importance of early angiography. Arch Surg 133:1099–1102PubMedCrossRef
Metadata
Title
Combined percutaneous thrombin injection and endovascular treatment of gastroduodenal artery pseudoaneurysm (PAGD): case report
Authors
Gianpaolo Carrafiello
Domenico Laganà
Chiara Recaldini
Monica Mangini
Domenico Lumia
Andrea Giorgianni
Anna Leonardi
Carlo Fugazzola
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Emergency Radiology / Issue 1/2007
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-007-0574-4

Other articles of this Issue 1/2007

Emergency Radiology 1/2007 Go to the issue