BACKGROUND: Although mesenteric angiography and embolization are established radiologic procedures, the evidence-base to aid decision making regarding selection of these procedures in the emergent situation in patients with hemorrhagic complications of pancreatitis is limited. METHODS: A retrospective analysis of 19 patients with hemorrhagic complications of pancreatic inflammatory disease (acute pancreatitis, chronic pancreatitis, and pseudocyst) referred over a 4-year period and identified at the point of mesenteric angiography in order to determine the influence of interventional radiologic maneuvers on outcome. RESULTS: Mesenteric angiography localized bleeding in 15 (79%), with 11 (58%) embolizations undertaken. There was one (9%) procedure-related complication and 3 (27%) rebleeds. Of 11 patients undergoing embolization, 8 (73%) required no further intervention for bleeding and 8 (73%) survived. CONCLUSIONS: Mesenteric angiography is valuable in localizing bleeding in patients with major vascular complications of pancreatic inflammatory disease. Angiographic embolization can achieve definitive hemostasis and stabilize a critically ill patient to permit disease reappraisal.
BACKGROUND: Although mesenteric angiography and embolization are established radiologic procedures, the evidence-base to aid decision making regarding selection of these procedures in the emergent situation in patients with hemorrhagic complications of pancreatitis is limited. METHODS: A retrospective analysis of 19 patients with hemorrhagic complications of pancreatic inflammatory disease (acute pancreatitis, chronic pancreatitis, and pseudocyst) referred over a 4-year period and identified at the point of mesenteric angiography in order to determine the influence of interventional radiologic maneuvers on outcome. RESULTS: Mesenteric angiography localized bleeding in 15 (79%), with 11 (58%) embolizations undertaken. There was one (9%) procedure-related complication and 3 (27%) rebleeds. Of 11 patients undergoing embolization, 8 (73%) required no further intervention for bleeding and 8 (73%) survived. CONCLUSIONS: Mesenteric angiography is valuable in localizing bleeding in patients with major vascular complications of pancreatic inflammatory disease. Angiographic embolization can achieve definitive hemostasis and stabilize a critically ill patient to permit disease reappraisal.
Authors: J R A Skipworth; C Morkane; D A Raptis; L Kennedy; K Johal; D Pendse; D J Brennand; S Olde Damink; M Malago; A Shankar; C Imber Journal: Ann R Coll Surg Engl Date: 2011-05 Impact factor: 1.891
Authors: Thomas K Maatman; Mark A Heimberger; Kyle A Lewellen; Alexandra M Roch; Cameron L Colgate; Michael G House; Attila Nakeeb; Eugene P Ceppa; C Max Schmidt; Nicholas J Zyromski Journal: Can J Surg Date: 2020-05-21 Impact factor: 2.089
Authors: H Bergert; F Dobrowolski; S Caffier; A Bloomenthal; I Hinterseher; H D Saeger Journal: Langenbecks Arch Surg Date: 2004-06-02 Impact factor: 3.445
Authors: Nicholas J Zyromski; Carlos Vieira; Michael Stecker; Attila Nakeeb; Henry A Pitt; Keith D Lillemoe; Thomas J Howard Journal: J Gastrointest Surg Date: 2007-01 Impact factor: 3.452