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KMID : 0614620070500020108
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Korean Journal of Gastroenterology
2007 Volume.50 No. 2 p.108 ~ p.115
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Clinical Features of Pseudoaneurysms Complicating Pancreatitis: Single Center Experience and Review of Korean Literature
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Kim Ji-Hyun
Han Woo-Sik
Kim Youn Ho
Yeon Jong-Eun
Park Jong-Jae
Byun Kwan-Soo
Park Young-Tae
Kim Jae-Seon
Kim Chang-Duck
Lee Hong-Sik
Cho Young-Jig
Lee Jong-Sup
Choi Do-Won
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Abstract
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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. (Korean J Gastroenterol 2007;50:108-115)
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KEYWORD
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Pseudoaneurysm, Pancreatitis, Embolization, Arterial
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