Angiographic embolization is an effective treatment of severe hemorrhage in pancreatitis

John Fitzpatrick, Raj Bhat, Jamie A. Young

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    Objective: The aim of this study was to analyze the role of radiologic embolization as a diagnostic and therapeutic modality for severe hemorrhage in pancreatitis.

    Methods: All patients with pancreatitis who underwent mesenteric angiography for a 3-year period were identified and analyzed retrospectively.

    Results: Nine separate bleeding episodes were treated with embolization (mean age, 56 years). This consisted of 6 patients who underwent primary angiographic embolization, with 3 patients requiring further embolization because of repeated bleeding from a different site. Most patients (83%) had chronic disease. The causative arteries were identified as splenic (6/9 patients), gastroduodenal (1/9 patients), left gastric (1/9 patients), and a small branch of the inferior mesenteric (1/9 patients). Clinical presentations were abdominal pain (3/9 patients), melena (3/9 patients), bleeding into retroperitoneal drain (2/9 patients), and hematemesis (1/9 patients). Bleeding was severe with an average drop in hemoglobin level of 6.3 g/dL. Of the 3 patients who required further embolization, all had splenic artery pseudoaneurysms and 2 patients experienced chronic pancreatitis with necrosis and proven peripancreatic infections. In all cases (9/9 patients), angiography succeeded in identifying and embolizing the causative vessel with a 1-year mortality of 0%.

    Conclusions: Angiographic embolization is an effective treatment of the life-threatening bleeding that occurs secondary to pancreatitis.

    (C) 2014 by Lippincott Williams & Wilkins.
    Original languageEnglish
    Pages (from-to)436-439
    Number of pages4
    JournalPancreas
    Volume43
    Issue number3
    DOIs
    Publication statusPublished - Apr 2014

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