1/18. Sudden death due to rupture of the arteria pancreatica magna: a complication of an immature pseudocyst in chronic pancreatitis.Massive haemorrhage due to rupture of single pancreatic or peripancreatic vessels is a very rare but potentially lethal complication of acute and chronic pancreatitis. The splenic, gastroduodenal, and pancreatoduodenal arteries are the more commonly involved vessels, and rupture occurs mostly as a complication of large mature pseudocysts. We report a sudden death due to massive bleeding caused by rupture of the great pancreatic artery (arteria pancreatica magna), a complication of a small immature pseudocyst, in a 49-year-old male alcoholic with inactive chronic pancreatitis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/18. Differentiation of cystic pancreatic lesions by echo-enhanced sonography with pulse inversion imaging - presentation of case reports.Echo-enhanced sonography is useful for differential diagnosis of pancreatic tumours. We present several criteria for the differentiation of cystic pancreatic lesions with this procedure using three selected patients. Cystadenomas frequently show many vessels along the fibrotic strands. On the other hand, cystadenocarcinomas are poorly and chaotically vascularised. "Young pseudocysts" frequently show a highly vascularised wall. However, the wall of "old pseudocysts" is poorly vascularised. CONCLUSION: Cystic pancreatic masses have a different vascularisation pattern when examined by echo-enhanced sonography. These characteristics can be useful for their differential diagnosis, but histology is still the "gold standard."- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/18. Spontaneous subcapsular splenic hematoma: a rare complication of pancreatitis.Subcapsular hematoma of the spleen is a rare complication of pancreatitis despite its close proximity to the pancreas. pancreatic pseudocyst involving the tail of the pancreas may erode into the splenic hilum causing hilar vessel bleeding with subcapsular dissection and hematoma formation. The management of such complication is still controversial. It has been suggested that most of these complications spontaneously regress and therefore can be managed conservatively. A case of spontaneous splenic subcapsular hematoma resulting from pancreatitis was managed conservatively with a good outcome.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
4/18. pancreatic pseudocyst bleeding associated with massive intraperitoneal hemorrhage.BACKGROUND: pancreatic pseudocyst bleeding is an unusual entity of acute abdomen, usually occurring among alcoholics. A high mortality developed in patients with conservative treatment of hemorrhagic pancreatic pseudocyst. We report a 37-year-old male with a pseudoaneurysm in the tail of the pancreas presenting with sudden onset of abdominal pain and swelling. Emergency laparotomy after blood transfusion and fluid resuscitation was successfully performed. methods: An abdominal radiography showed multiple calcifications in the epigastric area. Computed tomography of the abdomen showed a cystic lesion with a calcified wall in the tail of the pancreas and a large amount of ascites. After contrast enhancement, there was hemorrhage into the pancreatic pseudocyst with extravasation of contrast into the peritoneal cavity. RESULTS: At operation, active bleeding was noted from a ruptured pseudocyst in the tail of the pancreas and ligation of the bleeding vessel was done. CONCLUSIONS: Hemorrhage into the pancreatic pseudocyst associated with intraperitoneal bleeding is a potentially life threatening condition. Emergency surgical treatment should be carried out as soon as possible.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
5/18. Sonographic diagnosis of a splenic artery pseudoaneurysm incorporated within an infected pancreatic pseudocyst.In pancreatitis the involvement of adjacent vessels resulting in pseudoaneurysm formation is well known, though quite rare (Gadacz 1978, Kadell & Riley 1967). The diagnosis is usually established on angiography or surgery. We report here a case where the diagnosis of a splenic artery pseudoaneurysm incorporated within an infected pseudocyst, was made sonographically.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/18. Successful transcatheter embolization of pseudoaneurysm associated with pancreatic pseudocyst.Hemorrhage into a pancreatic pseudocyst is a rare event, but is the most rapidly lethal complication of chronic pancreatitis. Visceral-vessel aneurysms are an unexpectedly common finding in arteriography of patients with chronic pancreatitis. This case report describes bleeding from an anterior superior pancreaticoduodenal artery aneurysm, caused by chronic pancreatitis. The aneurysm was successfully treated by embolization with a steel coil.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
7/18. Detection of preoperatively unrecognized multiple pancreatic pseudocysts by intraoperative ultrasonography. Report of two cases.During two pancreatic operations, intraoperative ultrasonography detected multiple pancreatic pseudocysts that were unrecognized preoperatively. In each operation, a single pseudocyst was detected by preoperative ultrasonography, computed tomography, and intraoperative surgical exploration. In addition, high-resolution ultrasonography used during the operations also identified and precisely localized additional smaller pseudocysts. Also, the use of color Doppler imaging during the operations enabled the delineation of small blood vessels around the pseudocysts. The accurate diagnosis of multiple pseudocysts and the precise anatomic information provided by intraoperative ultrasonography permitted appropriate surgical treatment of the pancreatic pseudocysts which, in turn, might help prevent recurrence of the disease.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
8/18. Massive haemorrhage in pancreatitis.Massive haemorrhage in pancreatitis is a very rare complication of pancreatitis but it is the most rapidly lethal, haemorrhage being the major cause of death in more than half of the fatal cases. We present three patients who illustrate this rare complication in its diversity of presentation, and advise that doctors should have a keen clinical awareness of this condition if there is to be an effective and expeditious management. An understanding of the condition, coupled with immediate treatment, using embolisation or laparotomy with direct ligation of the bleeding vessel, can be lifesaving.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
9/18. Severe hemorrhage associated with pancreatic pseudocysts: report of two cases.Severe hemorrhage from pancreatic pseudocysts is a rare condition that poses a diagnostic and therapeutic challenge. Two cases of preoperative intracystic bleeding and massive postoperative gastrointestinal hemorrhage observed during the last year form the basis of the present report. In the first patient, transcystic suture ligation of the bleeding vessel was necessary to control this life-threatening and dramatic condition--External drainage of the cyst was followed by an uneventful postoperative course. In the second patient, massive gastrointestinal bleeding occurred after cysto-gastrostomy, and neither endoscopy nor arteriography was able to identify the source. Despite aggressive medical and surgical therapy, the patient died. Massive intracystic or gastrointestinal hemorrhage caused by rupture of pseudoaneurysms into pancreatic pseudocysts still remains a rare but severe condition, difficult to treat and affected by high mortality rates. angiography should be performed routinely in the preoperative assessment of pancreatic pseudocysts, even when the other diagnostic techniques do not raise the suspicion of pseudoaneurysm formation. After internal drainage procedures early surgery is recommended whenever GI bleeding occurs in the postoperative course.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
10/18. gastrointestinal hemorrhage from pseudoaneurysms in pancreatic pseudocysts.gastrointestinal hemorrhage secondary to hemosuccus pancreaticus is a rare condition that poses a significant diagnostic and therapeutic challenge. It is reported to occur most commonly in the setting of acute or chronic pancreatitis with rupture of pseudoaneurysms of the spleen or hepatic artery into the pancreatic duct. In this report three such cases have been reported. Abdominal ultrasound and CT scanning can noninvasively define pancreatic pseudocysts with a high degree of accuracy. Real-time ultrasonography may document a pulsatile pseudoaneurysm. Radionuclide arterial scanning, by demonstrating pooling of blood in the area of a pseudocyst, can point to the source of bleeding in patients with pancreatitis and gastrointestinal hemorrhage. Selective celiac angiography, however, is the only diagnostic test that can definitively outline a pseudoaneurysm and demonstrate its rupture into a pseudocyst or into the pancreatic duct. Pancreatic resection including excision of the pseudoaneurysm and pseudocyst (when present) is the treatment of choice. In cases where resection is not possible, ligation of the artery proximal and distal to the pseudoaneurysm and drainage of the pseudocyst into the gastrointestinal tract is an acceptable alternative procedure. Although intraarterial catheter embolization of the bleeding vessel can be a lifesaving procedure in these very sick patients, subsequent resection of the lesion is warranted as the definitive treatment.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
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