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KMID : 0985520160210010040
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Korean Journal of Pancreas and Biliary Tract
2016 Volume.21 No. 1 p.40 ~ p.44
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Hemosuccus Pancreaticus due to Intraductal Pseudoaneurysm
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이예진:Lee Ye-in
현종진:Hyun Jong-Jin/최주희:Choi Ju-Hee/심유라:Sim Yu-Ra/오홍권:Oh Hong-Kwon/김환일:Kim Hwan-Il/이홍식:Lee Hong-Sik/김창덕:Kim Chang-Duck
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Abstract
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Pseudoaneurysm is one of life-threatening complications of chronic or acute pancreatitis. It can lead to massive bleeding into the abdominal cavity, the retroperitoneum, or the gastrointestinal tract. Hemosuccus pancreaticus, meaning hemorrhage through the pancreatic duct into the duodenum is an important diagnostic clue suggesting the presence of pancreatic pseudoaneurysm. A 74-year-old man presented with hematochezia and active bleeding from the ampulla of Vater was noted on upper endoscopy. Abdominal computed tomography scan demonstrated a nodular enhancing lesion within the pancreatic duct. Celiac trunk angiography also showed a nodular enhancing lesion suggesting pseudoaneurysm in the pancreas. However, due to the difficulty of identifying the feeder artery of pseudoaneurysm by selective angiography, embolization was not feasible. Therefore, distal pancreatectomy was performed and ruptured pseudoaneurysm within the pancreatic duct could be confirmed. Herein, we report a case of hemosuccus pancreaticus due to ruptured intraductal pseudoaneurysm that was successfully treated by surgical management.
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KEYWORD
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Pancreatitis, Pseudoaneurysm, Hemosuccus pancreaticus, Angiography, Pancreatectomy
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