Imaging Diagnosis and Transcatheter Arterial Embolization for Massive Hemorrhage Due to Pseudoaneurysms Complicating Pancreatitis

  Objective  To discuss the imaging diagnosis of massive hemorrhage due to pseudoaneurysms complicating pancreatitis and evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in treating this disease.

  Methods  For 6 patients with massive hemorrhage due to pseudoaneurysms complicating pancreatitis, the clinical manifestations, imaging findings, TAE procedures, complications, and follow-up were retrospectively analyzed.

  Results  The locations of these 6 pseudoaneurysms included splenic artery (n=3), gastroduodenal artery (n=1), right gastroepiploic artery (n=1), and inferior pancreatioduodenal artery (n=1). Four pseudoaneurysms were detected by contrast-enhanced computed tomography (CT) and all were showed in digital subtraction angiography (DSA). TAE was performed as the first-choice management and the hemorrhage was controlled in all cases. Both the technical and clinical success rates reached 100% and no major complications occurred.

  Conclusions  For pseudoaneurysms complicating pancreatitis, contrast-enhanced CT and DSA are ideal imaging methods. TAE is safe and effective and should be the treatment of choice for this disease.