Korean J Gastroenterol.  2007 Aug;50(2):108-115.

Clinical Features of Pseudoaneurysms Complicating Pancreatitis: Single Center Experience and Review of Korean Literature

• Kim JH
• Kim JS
• Kim CD
• Lee HS
• Cho YJ
• Lee JS
• Choi DW
• Han WS
• Kim YH
• Yeon JE
• Park JJ
• Byun KS
• Bak YT

Abstract

BACKGROUND/AIMS: Pseudoaneurysm is a life-threatening complication of chronic or acute pancreatitis. This study was undertaken to evaluate the clinical features of pseudoaneurysm complicating pancreatitis. METHODS: We reviewed the medical records of 7 patients diagnosed as pseudoaneurysms with chronic pancreatitis in Korea University Guro and Anam Hospital from January 1995 to March 2006 and analyzed their demographics, clinical courses and outcomes. RESULTS: All patients were men and mean age was 54.6 years (range, 43-67 years). All the cases occurred in the setting of chronic alcoholic pancreatitis complicated by pseudocyst. Abdominal pain was the unique initial clinical symptom in 5 cases, hematemesis in 1 case, and simultaneous abdominal pain with hematemesis in 1 case. Bleeding into pseudocyst developed in 5 cases, flowing into duodenum through pancreatic duct in 1 case and rupture into the descending colon in 1 case. Mean duration between onset of symptom and diagnosis of pseudoaneurysm was 7.8 days (range, 1-23 days). Six cases were diagnosed by abdominal computed tomography disclosing characteristic finding of focal high density area in the pseudocyst. Pulsed doppler abdominal sonography was performed before computed tomography in 3 cases and results were negative in 2 cases. Transcatheter arterial embolizations were initially performed in 6 cases, and there was no recurrent bleeding except one case of splenic infarction. Distal pancreatectomy was initially performed in 1 case. CONCLUSIONS: Pseudoaneurysms complicating chronic pancreatitis shows various clinical features. Transcatheter arterial embolization can be recommended as a primary therapeutic modality.

Keyword

Pseudoaneurysm; Pancreatitis; Embolization, Arterial

MeSH Terms

Adult
Aged
Aneurysm, False/*diagnosis/etiology/ultrasonography
Arteries/injuries
Demography
Embolization, Therapeutic
Hemorrhage/etiology/surgery
Humans
Korea
Male
Middle Aged
Pancreatic Pseudocyst/etiology/surgery
Pancreatitis, Alcoholic/*complications/pathology
Retrospective Studies
Tomography, X-Ray Computed