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J Gastrointest Surg 2020 Jun 15. Epub 2020 Jun 15.

Division of Surgical Gastroenterology, Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Quant Imaging Med Surg 2020 May;10(5):1162-1168

Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Surg Case Rep 2020 Jun 1;6(1):122. Epub 2020 Jun 1.

Department of Surgery, Ibaraki Prefectural Central Hospital & Cancer Center, 6528 Koibuchi, Kasama, Ibaraki, 309-1793, Japan.

Background: Hemorrhage due to a ruptured splanchnic pseudoaneurysm followed by the formation of a postoperative pancreatic fistula is the most severe complication of a pancreatectomy, sometimes leading to a fatal outcome. Stent graft placement to control the hemorrhage due to the pseudoaneurysm is a validated treatment option, but once the stent graft is infected, infection control is complicated. We report a case of a ruptured pseudoaneurysm of the splanchnic artery after pancreaticoduodenectomy to evaluate the stent graft treatment. Read More

Clin J Gastroenterol 2020 May 28. Epub 2020 May 28.

Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.

A 48-year-old man presented with epigastralgia and back pain. Radiological evaluation revealed a pancreatic tail tumor with contrast enhancement and an intratumoral fluid component involving the splenic artery and invading the left kidney. Endoscopic ultrasound-guided fine-needle aspiration biopsy revealed an adenocarcinoma, and based on invasion of the left kidney, the patient was diagnosed with unresectable pancreatic cancer with suspected peritoneal dissemination. Read More

Int J Surg Case Rep 2020 8;71:91-94. Epub 2020 May 8.

Department of Surgery, Division of Hepatobiliary Pancreatic Surgery, Asklepios Hospital Barmbek, Hamburg, Germany; Semmelweis University of Medicine, Asklepios Campus Hamburg, Hamburg, Germany.

Introduction: Portal Vein Arterialization is a rare procedure for total de-arterialized livers to ensure arterial inflow to the liver.

Presentation Of Case: A 55-year-old male patient underwent pancreatoduodenectomy for chronic pancreatitis. One month after discharge the patient was re-admitted because of bleeding from a pseudoaneurysm of the ligated gastroduodenal artery. Read More

Ann Vasc Surg 2020 May 16. Epub 2020 May 16.

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. Electronic address:

Visceral artery pseudoaneurysm (PSA) complicated by pancreatitis is a relatively rare and potentially life-threatening condition. The formation of pancreatic PSA is mainly attributed to continuous inflammation response, which induces the enzymatic autodigestion of the adjacent artery wall. The spleen artery is the most affected vessel, and other vessels such as gastroduodenal artery (GDA) and pancreaticoduodenal artery are usually involved. Read More

Case Rep Gastroenterol 2020 Jan-Apr;14(1):131-136. Epub 2020 Apr 8.

Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, Republic of Korea.

Hemorrhagic pseudocyst (HP) and pseudocyst-associated pseudoaneurysms (PPs) are complications of pseudocyst. Angiography with embolization has been advocated as the first-line intervention for HP. A 47-year-old man with groove pancreatitis combined with HP near the pancreatic head was treated conservatively. Read More

Langenbecks Arch Surg 2020 May 23;405(3):325-336. Epub 2020 Apr 23.

Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, 520-2192, Japan.

Purpose: Perianastomotic fluid collection (PFC) is one of the postoperative complications of pancreaticoduodenectomy (PD). However, no studies have investigated the clinical significance of PFC location and volume during the early postoperative period. This study aimed to assess the association between PFC during the early postoperative period and postoperative complications. Read More

Vasc Endovascular Surg 2020 Jul 22;54(5):455-457. Epub 2020 Apr 22.

Upper Gastrointestinal and Hepatobiliary Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.

We report a case of a 54-year-old male presenting to a regional hospital with severe hematemesis and hemodynamic instability. His medical history was significant for a previous episode of alcoholic necrotizing pancreatitis and pseudocyst, requiring cystoenterostomy drainage and debridement 10 years prior. He underwent multiple gastroscopies and one emergency laparotomy which failed to definitively treat the bleeding. Read More

Transplant Proc 2020 Apr 16. Epub 2020 Apr 16.

Department of General and Transplantation Surgery, Central Clinical Hospital, Ministry of the Interior, Warsaw, Poland; Centre of Postgraduate Medical Education, Warsaw, Poland.

Pseudoaneurysm is a rare vascular complication in pancreas transplantation that can lead into life-threatening situations. A 44-year-old male patient after simultaneous pancreas-kidney transplant was admitted to the hospital for routine tests 3 months after surgery. A computed tomography scan and ultrasound examination were done, and a diagnosis of pseudoaneurysm was made. Read More

GE Port J Gastroenterol 2020 Feb 7;27(2):115-118. Epub 2019 Aug 7.

Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.

Cystic artery pseudoaneurysm (CAP) is a rare entity most often resulting from inflammatory conditions (acute cholecystitis or pancreatitis) or iatrogenic trauma (cholecystectomy). We report the case of a 73-year-old female who presented with abdominal pain and gastrointestinal bleeding after an episode of acute cholecystitis and endoscopic retrograde cholangiopancreatography for choledocolithiasis removal. Computed tomography and angiography revealed a CAP measuring 5 cm. Read More

J Clin Med 2020 Mar 21;9(3). Epub 2020 Mar 21.

Gastroenterology and Digestive Endoscopy Unit, AOU Città della Salute e della Scienza, University of Turin, 10126 Turin, Italy.

Endoscopic injection of glues, clotting factors, or sclerosing agents is a well-known therapy for the treatment of non-variceal upper gastrointestinal bleeding (NVUGIB), but less is known about endoscopic ultrasound (EUS)-guided treatments. In this setting, literature data are scarce, and no randomized controlled trials are available. We performed a review of the existing literature in order to evaluate the role of EUS-guided therapies in the management of NVUGIB. Read More

Hepatobiliary Pancreat Dis Int 2020 Mar 13. Epub 2020 Mar 13.

Department of Abdominal Radiology, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Radiographics 2020 May-Jun;40(3):667-683. Epub 2020 Mar 27.

Department of Diagnostic Radiology (S.S., M.S., M.K., Y.A.) and Department of Hepatobiliary and Pancreatic Oncology (S.H., Y.S.), National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; and Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Hospital, Minamiuonuma, Niigata, Japan (S.M.).

Endoscopic US-guided biliary drainage (BD) is performed for various types of biliary obstruction and is mainly indicated for unsuccessful conventional transpapillary endoscopic retrograde cholangiodrainage. In endoscopic US BD, an extra-anatomic drainage route between the gastrointestinal (GI) tract and the biliary system is created with a covered metallic stent or plastic stent. Procedural types of endoscopic US BD include hepaticogastrostomy, hepaticojejunostomy (after gastrectomy), choledochoduodenostomy, hepaticoduodenostomy, and endoscopic US-guided gallbladder drainage. Read More

Am J Emerg Med 2020 Mar 12. Epub 2020 Mar 12.

Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, United States of America.

Pancreatic pseudocysts are seen both in acute and chronic pancreatitis. Prevalence of pancreatic pseudocyst in chronic pancreatitis is 20% to 40% and is most commonly seen in alcoholic chronic pancreatitis. Intracystic hemorrhage from a pseudoaneurysm is a rare and potentially a lethal complication of pancreatic pseudocyst with an incidence of less than 10%. Read More

Ann Hepatobiliary Pancreat Surg 2020 Feb 27;24(1):114-118. Epub 2020 Feb 27.

Division of Transplantation and Hepatopancreatobiliary Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.

Aim of the study is the description of the successful management of gastroepiploic artery pseudoaneurysm with preservation of parent vessels using flow-diversion technology. The present report describes the application of a flow-diversion Pipeline™ Flex device for occlusion of a sidewall bleeding pseudoaneurysm on a patient who was status-post sub-total pancreatectomy and remote esophagectomy with a gastric conduit. The pseudoaneurysm was on the solitary vessel supplying the patient's conduit. Read More

J Surg Case Rep 2020 Feb 21;2020(2):rjz407. Epub 2020 Feb 21.

Department of Interventional Radiology, University Hospital of Larissa, Larissa, Greece.

Preventing and curing complications of acute and chronic pancreatitis, which may be local or systemic, remains a challenge. Pseudocysts and walled-off pancreatic necrosis are two local complications that most frequently require surgical intervention. Two rare complications of pancreatitis are pseudoaneurysms and pulmonary embolism. Read More

Diagn Interv Imaging 2020 Feb 20. Epub 2020 Feb 20.

Department of Urology, Nantes University Hospital, University of Medicine of Nantes, 44093 Nantes, France.

Pancreas transplantation exposes to high rates of complications, either vascular (thrombosis, stenosis, pseudoaneurysm, arteriovenous fistula) or nonvascular (fluid collection, graft rejection). With advances in percutaneous and endovascular techniques, interventional radiologists are increasingly involved in the management of these complications. In this article, we review the anatomical considerations relevant to pancreas transplantation, the techniques used for image-guided interventions for vascular and nonvascular complications, and the expected outcomes of these interventions. Read More

Transplant Proc 2020 Mar 17;52(2):660-666. Epub 2020 Feb 17.

Department of Surgery, Westmead Hospital, Sydney, Australia; Discipline of Surgery, University of Sydney Medical School, Sydney, Australia; National Pancreas Transplant Unit, Westmead Hospital, Sydney, Australia. Electronic address:

Introduction: Mycotic pseudoaneurysm is a rare complication of pancreas transplantation. Successful management relies on early diagnosis and expedient treatment comprising surgery and antibiotics. While the standard of care in recipients of pancreatic transplants is open repair of pseudoaneurysm with or without excision of the allograft, endovascular management has been reported. Read More

Zhonghua Wai Ke Za Zhi 2020 Feb;58(2):114-118

Department of Hepato-Biliary-Pancreatic Surgery Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen's pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD). Clinical data of 116 consecutive patients who underwent LPD using Chen's pancreaticojejunostomy technique in Hunan Provincial People's Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. Read More

Surg Case Rep 2020 Feb 18;6(1):38. Epub 2020 Feb 18.

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya City, 464-8681, Japan.

Background: Postoperative bleeding originating from pseudoaneurysms after radical gastrectomy is not common, but it can be fatal. In particular, delayed bleeding that occurs after the seventh postoperative day is rare.

Case Presentation: A 54-year-old man underwent laparoscopic distal gastrectomy, D2 lymph node dissection, and Roux en-Y reconstruction for duodenal neuroendocrine tumors. Read More

J Ayub Med Coll Abbottabad 2019 Oct-Dec;31(4):622-626

Department of Pulmonary, critical care and sleep medicine, Bridgeport Hospital, Yale-New Haven Health, Bridgeport, United States.

Hemosuccus pancreaticus (HP) defined as bleeding into the pancreatic duct was first described in 1931 by Lower and Farell. HP also popularly known as wirsungorrhaghia and pseudohemobilia is a rare cause of gastrointestinal bleed. The unfamiliarity of this condition makes HP a diagnostic challenge. Read More

J Popul Ther Clin Pharmacol 2019 Dec 27;26(4):e32-e36. Epub 2019 Dec 27.

2nd Department of General Surgery, General Hospital of Athens "Evangelismos," Athens, Greece.

Post-pancreaticoduodenectomy hemorrhage has an estimated incidence of 5% and a mortality rate of 11-38%. Vascular erosion resulting from pancreatic leak and skeletonization of the arterial wall during pancreatic mobilization may be the two possible mechanisms responsible for this complication, which most commonly affects the gastroduodenal artery stump. A novel technique of wrapping up the gastroduodenal artery stump into the jejunal serosa to decrease postoperative hemorrhage is presented. Read More

BMJ Case Rep 2019 Dec 29;12(12). Epub 2019 Dec 29.

Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA.

Abdom Radiol (NY) 2020 05;45(5):1253-1264

Stanford University Department of Radiology, 300 Pasteur Drive H1307, Stanford, CA, 94305, USA.

Ultrasound plays an essential role in the initial evaluation of patients with suspected or confirmed acute pancreatitis. In addition to evaluation of the pancreatic parenchyma, ultrasound is used for assessment of the gallbladder, biliary tree, peripancreatic tissues, and regional vascular structures. While enlarged and edematous pancreas are classic sonographic features of acute pancreatitis, the pancreas may appear sonographically normal in the setting of acute pancreatitis. Read More

BJS Open 2019 12 30;3(6):735-742. Epub 2019 Sep 30.

Centre for Tumour Biology, Barts Cancer Institute Queen Mary University of London London UK.

Background: Gastroduodenal artery (GDA) pseudoaneurysm is a serious complication following pancreatic resection, associated with high morbidity and mortality rates. This review aimed to report the incidence of GDA pseudoaneurysm after pancreatic surgery, and describe clinical presentation and management.

Methods: MEDLINE and Embase were searched systematically for clinical studies evaluating postoperative GDA pseudoaneurysm. Read More

Surg Case Rep 2019 Dec 9;5(1):192. Epub 2019 Dec 9.

Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan.

Background: When a postoperative hepatic artery pseudoaneurysm develops after massive hepatectomy, both an intervention for the pseudoaneurysm and patency of hepatic artery should be considered because occlusion of the residual hepatic artery results in critical liver failure. However, the treatment strategy for a pseudoaneurysm of the hepatic artery after hepatobiliary resection is not well established.

Case Presentation: A 65-year-old woman underwent right hepatectomy, extrahepatic duct resection, and portal vein resection, for gallbladder cancer. Read More

Surg Case Rep 2019 Dec 2;5(1):187. Epub 2019 Dec 2.

Department of Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524, Japan.

Background: Ruptured pseudoaneurysms are a rare complication of gastrectomy, but when they do develop, they are often fatal. We presented herein the first report of a case of pseudoaneurysm arising from the right inferior phrenic artery (RIPA) after a laparoscopic gastrectomy.

Case Presentation: A 61-year-old male patient underwent a laparoscopic distal gastrectomy and D1+ lymph node dissection with Roux-en-Y reconstruction for early gastric cancer. Read More

Case Rep Gastroenterol 2019 Sep-Dec;13(3):450-455. Epub 2019 Oct 30.

Gastroenterology and Hepatology, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA.

Pancreatic pseudoaneurysm is a rare vascular complication of pancreatitis, resulting from erosion of the pancreatic or peripancreatic artery into a pseudocyst. However, it may happen after pancreatic or gastric bypass surgery or trauma. It may lead to fatal complications if left untreated. Read More

Abdom Radiol (NY) 2020 05;45(5):1290-1298

The Russell H. Morgan, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA.

Inflammation of the pancreas can present with a wide range of imaging findings from mild enlargement of the gland and surrounding infiltrative fat stranding through extensive glandular necrosis. Complications of pancreatitis are varied and include infected fluid collections, pseudocysts, and vascular findings such as pseudoaneurysms and thromboses. Cross-sectional imaging with computed tomography (CT) is one of the mainstays of evaluating patients with pancreatitis. Read More

ACG Case Rep J 2019 May 10;6(5):e00078. Epub 2019 May 10.

College of Medicine, University of Tennessee, Chattanooga, TN.

A 43-year-old man with a history of pedestrian-truck collision 18 months prior presented with right-sided abdominal pain and chills. His trauma consisted of orthopedic injuries and a grade 4 liver laceration. Surgical liver repair was complicated by a biloma requiring common bile duct stenting. Read More

World J Clin Cases 2019 Sep;7(18):2851-2856

Department of Biliary-Pancreatic Minimally Invasive Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.

Background: Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. Read More

BMC Surg 2019 Sep 18;19(1):139. Epub 2019 Sep 18.

Department of GI & General Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, P. O - 1524, Kathmandu, 00977, Nepal.

Background: Chronic pancreatitis is a progressive and persistent inflammatory disease resulting in pancreatic insufficiency leading to diabetes and steatorrhea. Abdominal pain is the most debilitating feature and is often refractory to treatment. Medical management with adequate analgesia and replacement of pancreatic enzyme supplements is the first line in management of chronic pancreatitis. Read More

Nihon Shokakibyo Gakkai Zasshi 2019 ;116(9):754-763

Department of Gastroenterology, National Hospital Organization Kyushu Medical Center.

A 51-year-old woman underwent endoscopic biliary drainage with a plastic stent for obstructive jaundice due to unresectable pancreatic head cancer. During chemotherapy following heavy ion therapy for the cancer, she presented with acute cholangitis and massive rectal bleeding. The massive hemorrhage was caused by rupture of the biliary duct due to a pseudoaneurysm in the right hepatic artery. Read More

Ann Gastroenterol 2019 Sep-Oct;32(5):441-450. Epub 2019 Jul 22.

Department of Surgery (Rajesh Gupta), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

The development of endoscopic ultrasound (EUS)-guided drainage techniques and lumen-apposing metal stents (LAMS) has markedly reduced the complication rate of endoscopic transmural drainage of pancreatic collections and made these procedures safer and more effective. Despite its improved safety profile, various types of complications, some even life-threatening, can occur after EUS-guided drainage of pancreatic fluid collections. Stent maldeployment/migration, bleeding, gastrointestinal perforation, and air embolism are important complications of EUS-guided drainage of pancreatic collections. Read More

Medicine (Baltimore) 2019 Jul;98(28):e16442

Cardiovascular Center, The First Hospital of Jilin University, Chang Chun, Jilin Province, China.

Rationale: Visceral arterial pseudoaneurysms are rare but important vascular entities because of their inclination to cause life-threatening hemorrhage. They were commonly reported to be associated with trauma, infection, inflammatory disease, or occurred as postoperative complication. To date, there has been no published report of a superior mesenteric artery (SMA) branch pseudoaneurysm rupture mimicking acute pancreatitis in a patient with acute type B aortic dissection. Read More

Vasc Endovascular Surg 2019 Oct 27;53(7):593-598. Epub 2019 Jun 27.

3 Department of Cardiovascular Surgery, Nagoya Tokushukai General Hospital, Kasugai City, Japan.

The association between pancreaticoduodenal artery aneurysm (PDAA) and local hemodynamic changes in pancreaticoduodenal arcades is well established. However, there are few case reports of PDAA associated with acute aortic dissection. In this article, we outline and discuss the case of a 61-year-old man diagnosed with a type A acute aortic dissection who underwent emergency surgery and developed sudden-onset severe abdominal pain and shock 10 days later. Read More

AJR Am J Roentgenol 2019 09 19;213(3):602-609. Epub 2019 Jun 19.

Department of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210 St, Bronx, NY 10467.

Lumen-apposing metal stents (LAMS) are increasingly being used for abdominopelvic drainage applications. The purpose of this article is to describe the normal imaging appearance of these stents and the radiologic findings in stent-related complications. LAMS facilitate effective drainage, but the complications include bleeding, pseudoaneurysm formation, stent occlusion, and stent migration. Read More

Surg Case Rep 2019 May 27;5(1):86. Epub 2019 May 27.

Department of Surgery, Chugoku Rousai Hospital, 1-5-1 Hirotagaya, Kure, Hiroshima, 737-0193, Japan.

Background: Duodenal duplication cysts in adults are rare, and a preoperative diagnosis remains difficult because clinical manifestations are nonspecific and variable. We describe a case of a duodenal duplication cyst mimicking a pancreatic pseudocyst with repeated intracystic hemorrhage.

Case Presentation: A 47-year-old male who complained of upper abdominal pain and vomiting was referred to our hospital. Read More

J Surg Case Rep 2019 May 16;2019(5):rjz124. Epub 2019 May 16.

Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands.

Pancreas transplantation is the most successful treatment option for patients with autoimmune type 1 diabetes. However, the surgical procedure is associated with high morbidity rates. The present case report describes a patient receiving simultaneous pancreas/kidney transplantation. Read More

BMJ Case Rep 2019 May 8;12(5). Epub 2019 May 8.

serviço de angiologia e cirurgia endovascular, Hospital de Base, São Paulo, Brazil.

Haemosuccus pancreaticus (HP) is an uncommon cause of upper gastrointestinal (GI) bleeding, most often intermittent, making it difficult to diagnose, becoming fatal. It usually occurs in patients with chronic pancreatitis and is caused by the rupture of a visceral aneurysm within the main pancreatic duct. The association between pseudoaneurysm formation and pancreatitis is well established. Read More

JGH Open 2019 Apr 27;3(2):140-147. Epub 2018 Dec 27.

Asian Institute of Gastroenterology Hyderabad India.

Background: Interventional radiology (IR) is an indispensable component of multidisciplinary care in various gastrointestinal (GI) diseases. The literature on safety and utility of IR is limited in children.

Objectives: In this study, we aim to analyze the outcomes of IR in various pediatric GI diseases. Read More

Clin J Gastroenterol 2019 Dec 23;12(6):615-620. Epub 2019 Apr 23.

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Pancreatic pseudocysts (PPs) can be accompanied by infection, pseudoaneurysm ruptures, and fistulae to other organs, which can be fatal without appropriate treatment. Herein, we present the case of an 82-year-old man with PPs accompanied by infection, pseudoaneurysm rupture, and pseudocystocolonic fistula that were managed via multidisciplinary treatment. Computed tomography (CT) revealed two inflamed PPs, one each in the pancreatic head and tail. Read More

Ann Transplant 2019 Apr 12;24:199-207. Epub 2019 Apr 12.

Department of Gastroenterological Surgery and Transplantation, Medical Centre of Postraguade Medicine, Warsaw, Poland.

BACKGROUND Vascular failures are serious complications in pancreas transplantation. Open surgery is a reliable and quick intervention method, but it carries a risk of infection and bleeding. Endovascular procedures are rare among patients after a SPK, but are becoming more frequently used. Read More

Nihon Shokakibyo Gakkai Zasshi 2019 ;116(4):344-352

Department of Gastroenterology, Hiroshima City Asa Citizens Hospital.

A man in his 40s with no remarkable past medical history was referred to our hospital with acute exacerbation of nonspecific epigastric pain by another hospital on the morning of the day of presentation. Though vital signs were stable, tenderness and guarding were observed over the entire abdomen. Contrast-enhanced computed tomography (CT) revealed a giant retroperitoneal hematoma due to a ruptured aneurysm close to the superior mesenteric artery. Read More

Rev Assoc Med Bras (1992) 2019 Feb;65(2):123-126

Department of Radiology, Soonchunhyang University Seoul Hospital, Yongsan-gu, Seoul, Korea.

Hemorrhagic pseudocysts with pseudoaneurysms are a rare and fatal complication of chronic pancreatitis due to the erosion of pancreatic to peripancreatic arteries. The timing of the rupture cannot be accurately predicted, but prompt diagnosis and management are essential to prevent further bleeding. We describe the case of a 68-year-old man who presented acute epigastric pain and anemia and had a history of chronic pancreatitis with a pseudocyst. Read More

Kaohsiung J Med Sci 2019 Jul 19;35(7):448-449. Epub 2019 Mar 19.

Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Case Rep Gastrointest Med 2019 6;2019:8528906. Epub 2019 Feb 6.

Clinical Assistant Professor, Department of Gastroenterology, Aurora St. Luke's Medical Center, 2900 W. Oklahoma Avenue, Milwaukee, WI 53215, USA.

Large upper gastro intestinal (GI) bleeding can be life-threatening. Splenic artery pseudoaenurysm (SAP) is rare but can cause massive upper GI bleeding. We report a case of a 57-year-old woman who had massive upper GI bleeding from SAP eroding into distal duodenum. Read More

BMJ Case Rep 2019 Mar 6;12(3). Epub 2019 Mar 6.

Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.

Haemosuccus pancreaticus (HP) is an exceedingly rare cause of lower gastrointestinal (GI) bleed where pseudoaneurysm of the peripancreatic vessels ruptures into a pancreatic pseudocyst and blood travel through the pancreatic duct, thereby, draining into GI tract via the ampulla of Vater. We present a case of 65-year-old African-American woman with a history of alcohol abuse presented with melena for 1 day. The contrast-enhanced CT of abdomen/pelvis showed peripancreatic vascular pseudoaneurysm with active haemorrhage. Read More

Langenbecks Arch Surg 2019 Mar 13;404(2):253-255. Epub 2019 Feb 13.

Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia.

Background: Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. Read More