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DOI: 10.1055/s-0031-1271540
© Georg Thieme Verlag KG Stuttgart ˙ New York
Milzarterienaneurysma nach Pankreatitis
Postpancreatitic Splenic Artery PseudoaneurysmPublication History
Publication Date:
18 July 2011 (online)

Zusammenfassung
Viszerale Pseudoaneurysmata sind eine seltene aber ernsthafte Komplikation bei Pankreatiden. Wir berichten im vorliegenden Fall über die endosonografische Diagnostik eines Milzarterienpseudoaneurysmas mit Pseudozystenbildung bei einem Patienten mit stattgehabter Pankreatitis. Ziel des vorliegenden Fallbeispieles ist es, einen kurzen Überblick zu den aktuellen Daten und Empfehlungen aus der Literatur bezüglich Diagnostik und Behandlungsstrategien bei Pankreatitis bedingter Pseudoaneurysmabildung zu geben. In unserem Fall hat sich der Patient bis heute gegen die empfohlenen Therapien ausgesprochen.
Abstract
Visceral artery pseudoaneurysm is a rare but serious complication in pancreatitis. We report about the endoscopic ultrasound (EUS) based diagnosis of a splenic artery pseudoaneurysm and pseudocyst in a patient with pancreatitis. In this context we aim to give a short overview about strategies in diagnosis and treatment of pancreatic pseudoaneurysm based on current literature. Despite medical recommendations our patient is refusing all therapeutic interventions.
Schlüsselwörter
Milzarterie - Pseudoaneurysma - Pankreatitis - Endosonografie - EUS
Key words
splenic artery - Pseudoaneurysm - pancreatitis - endoscopic ultrasound - EUS
Literatur
- 1 Bergert H et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery. 2005; 137 323-328
- 2 El Hamel A et al. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis. Br J Surg. 1991; 78 1059-1063
- 3 Boudghene F, L’Hermine C, Bigot J M. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol. 1993; 4 551-558
- 4 Mallick I CH, Winslet M C. Vascular complications of pancreatitis. Jop. 2004; 5 328-337
- 5 Mortele K J et al. Peripancreatic vascular abnormalities complicating acute pancreatitis: contrast-enhanced helical CT findings. Eur J Radiol. 2004; 52 67-72
- 6 Cahow C E, Gusberg R J, Gottlieb L J. Gastrointestinal hemorrhage from pseudoaneurysms in pancreatic pseudocysts. Am J Surg. 1983; 145 534-541
- 7 Sethi H et al. Selective embolization for bleeding visceral artery pseudoaneurysms in patients with pancreatitis. Hepatobiliary Pancreat Dis Int. 2010; 9 634-638
- 8 Reber P U, Uhl W, Buchler M W. [Pancreatic pseudocysts in chronic pancreatitis. Differential diagnosis and therapy]. Chirurg. 1997; 68 881-887
- 9 Stabile B E, Wilson S E, Debas H AT. Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. Arch Surg. 1983; 118 45-51
- 10 Koizumi J et al. Hemosuccus pancreaticus: diagnosis with CT and MRI and treatment with transcatheter embolization. Abdom Imaging. 2002; 27 77-81
- 11 Toyoki Y et al. Hemosuccus pancreaticus: problems and pitfalls in diagnosis and treatment. World J Gastroenterol. 2008; 14 2776-2779
- 12 Udd M et al. Treatment of bleeding pseudoaneurysms in patients with chronic pancreatitis. World J Surg. 2007; 31 504-510
- 13 Mauro M A, Jaques P. Transcatheter management of pseudoaneurysms complicating pancreatitis. J Vasc Interv Radiol. 1991; 2 527-532
- 14 Lameris R et al. A visceral pseudoaneurysm: management by EUS-guided thrombin injection. Gastrointest Endosc. 2011; 73 392-395
- 15 Will U et al. “Hemosuccus pancreaticus” – primarily ultrasound-guided successful intervention using transcutaneous fibrin glue application and histoacryl injection. Ultraschall Med. 2008; 29 260-263
- 16 Robinson M, Richards D, Carr N. Treatment of a splenic artery pseudoaneurysm by endoscopic ultrasound-guided thrombin injection. Cardiovasc Intervent Radiol. 2007; 30 515-517
- 17 Gonzalez J M et al. Endoscopic ultrasound treatment of vascular complications in acute pancreatitis. Endoscopy. 2009; 41 721-724
Dr. med. C. Schmöcker
Sana Klinikum Lichtenberg · Klinik für Innere Medizin I
Fanningerstr. 32
10365 Berlin
Email: c.schmoecker@sana-kl.de