TY - JOUR
T1 - Visceral Vessel Erosion Associated with Pancreatitis
T2 - Case Reports and a Review of the Literature
AU - Gadacz, Thomas R.
AU - Trunkey, Donald
AU - Kieffer, Richard F.
PY - 1978/12
Y1 - 1978/12
N2 - Visceral artery erosion is an uncommon but disasterous complication of pancreatitis. When gastrointestinal bleeding or severe intra-abdominal hemorrhage is associated with pancreatitis and the usual sources of bleeding are not detected by endoscopy or barium studies, erosion of a visceral vessel should be suspected. We present nine cases and an additional 44 cases from previous reports are reviewed. A palpable abdominal mass was present in 59% of the patients; however, a pseudocyst was present in 78%. Arteriography was performed in 15 patients and the source of bleeding was evident in 14. The splenic artery was the most common site of bleeding, although the other branches of the celiac axis and the middle colic artery have been involved. Successful treatment consisted of ligation of the bleeding vessel and, if present, drainage of the pseudocyst. Depending on the location of the vessel and the pseudocyst, major resections may be necessary. When bleeding and the pancreatic inflammatory process involved the colon, ligation of the bleeding site, drainage of the area, and colostomy was the most successful form of treatment.
AB - Visceral artery erosion is an uncommon but disasterous complication of pancreatitis. When gastrointestinal bleeding or severe intra-abdominal hemorrhage is associated with pancreatitis and the usual sources of bleeding are not detected by endoscopy or barium studies, erosion of a visceral vessel should be suspected. We present nine cases and an additional 44 cases from previous reports are reviewed. A palpable abdominal mass was present in 59% of the patients; however, a pseudocyst was present in 78%. Arteriography was performed in 15 patients and the source of bleeding was evident in 14. The splenic artery was the most common site of bleeding, although the other branches of the celiac axis and the middle colic artery have been involved. Successful treatment consisted of ligation of the bleeding vessel and, if present, drainage of the pseudocyst. Depending on the location of the vessel and the pseudocyst, major resections may be necessary. When bleeding and the pancreatic inflammatory process involved the colon, ligation of the bleeding site, drainage of the area, and colostomy was the most successful form of treatment.
UR - http://www.scopus.com/inward/record.url?scp=0018170269&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0018170269&partnerID=8YFLogxK
U2 - 10.1001/archsurg.1978.01370240060009
DO - 10.1001/archsurg.1978.01370240060009
M3 - Article
C2 - 310667
AN - SCOPUS:0018170269
SN - 0004-0010
VL - 113
SP - 1438
EP - 1440
JO - Archives of Surgery
JF - Archives of Surgery
IS - 12
ER -