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Velickovic D, Stosic K, Stefanovic AD, Kovac JD, Sekulic D, Milosevic S, Miletic M, Saponjski DJ, Lukic B, Tadic B, Jovanovic MM, Cvetic V. The Importance of Early Detection and Minimally Invasive Treatment of Pseudoaneurysms Due to Chronic Pancreatitis: Case Report. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:714. [PMID: 38792897 PMCID: PMC11123147 DOI: 10.3390/medicina60050714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
The occurrence of the pseudoaneurysm of visceral arteries in the field of chronic pancreatitis is a very rare complication that represents a life-threatening condition. The higher frequency of this complication is in the necrotic form of pancreatic inflammation, especially in patients with formed peripancreatic necrotic collections. The degradation of the arterial wall leads to bleeding and transforms these necrotic collections into a pseudoaneurysm. Urgent endovascular angioembolization is the first choice in the therapeutic approach as a valid minimally invasive solution with very satisfactory immediate and long-term outcomes. This successfully avoids open surgery, which is associated with a high mortality rate in these patients, especially in acute-on-chronic pancreatitis.
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Affiliation(s)
- Dejan Velickovic
- Department of Stomach and Esophageal Surgery, Clinic for Digestive Surgery, University Clinical Centre of Serbia, Koste Todorovica Street No. 6, 11000 Belgrade, Serbia
- Department for Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Katarina Stosic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
| | - Aleksandra Djuric Stefanovic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Jelena Djokic Kovac
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Danijela Sekulic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
| | - Stefan Milosevic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
| | - Marko Miletic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
| | - Dusan Jovica Saponjski
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Borivoje Lukic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Boris Tadic
- Department for Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
- Department for HPB Surgery, Clinic for Digestive Surgery, University Clinical Centre of Serbia, Koste Todorovica Street, No. 6, 11000 Belgrade, Serbia
| | - Milica Mitrovic Jovanovic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
| | - Vladimir Cvetic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Centre of Serbia, Pasterova No. 2, 11000 Belgrade, Serbia
- Department for Radiology, Faculty of Medicine, University of Belgrade, Dr Subotica No. 8, 11000 Belgrade, Serbia
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Inoue T, Tanaka T. A Case of Cecal Diverticulitis Complicated by Pseudoaneurysm in the Ileocolic Artery. Cureus 2022; 14:e25680. [PMID: 35812613 PMCID: PMC9259073 DOI: 10.7759/cureus.25680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/06/2022] Open
Abstract
Acute colonic diverticulitis is a common gastrointestinal illness. It has several complications, such as perforation, abscess, and fistula formation. In addition, pseudoaneurysm caused by diverticulitis has been reported. We report a case of cecal diverticulitis complicated by pseudoaneurysm in the ileocolic artery. A 58-year-old Japanese man was referred to our hospital for abdominal pain. Abdominal examination revealed right lower quadrant pain. Computed tomography (CT) scans showed the presence of diverticula and pericolic fat stranding in the cecum. Following this, he was diagnosed with cecal diverticulitis. Despite antibiotic treatment, his abdominal pain and blood test results worsened. On the third hospital day, a CT scan was performed again, revealing a pseudoaneurysm with hematoma in the ileocolic artery. Interventional radiology (IVR) was conducted to treat the pseudoaneurysm. It was embolized with n-butyl-2-cyanoacrylate (NBCA) and lipiodol. After embolization, he had stable hemoglobin. His abdominal pain and blood test results improved. Pseudoaneurysms have been reported as a rare complication for diverticulitis. When a rupture occurs, it has a high risk of mortality. Early diagnosis and treatment of pseudoaneurysms are essential, and we should consider pseudoaneurysms as a complication of acute colonic diverticulitis.
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Gaur NK, Shaikh O, S SS, Reddy A, Kumbhar U. Left Gastric Artery Pseudoaneurysm Due to Pancreatitis. Cureus 2021; 13:e20405. [PMID: 35036230 PMCID: PMC8754357 DOI: 10.7759/cureus.20405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/22/2022] Open
Abstract
Acute or chronic pancreatitis can cause pseudoaneurysms of visceral arteries. The left gastric artery (LGA) is the least common visceral artery being affected. Here, we report a case of chronic pancreatitis with a pseudoaneurysm of the LGA. A 42-year-old male, a chronic alcoholic, and smoker, presented with abdominal pain, haematemesis, and melena. Diagnosis of pseudoaneurysm of LGA aneurysm was confirmed by computed tomography abdomen. The endovascular coil embolization was done successfully, following which the patient had an uneventful recovery.
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