Laparoscopic distal pancreatectomy for hemosuccus pancreaticus due to an intraductal papillary mucinous neoplasm.
Takao IdeKazuya UchikawaHirokazu NoshiroPublished in: Asian journal of endoscopic surgery (2022)
Hemosuccus pancreaticus (HP) is a condition that is defined as gastrointestinal hemorrhage which occurs through the pancreatic duct. We present the rare case of a 75-year-old woman who developed HP caused by intraductal papillary mucinous neoplasm (IPMN). She had been followed for sarcoidosis, splenic artery aneurysm and pancreatic cyst. The patient presented to the emergency room of our hospital with epigastric pain and bloody discharge. Computed tomography revealed hemorrhage from a splenic artery aneurysm in a cystic lesion of the pancreas. On angiography, extravasation from the splenic artery was observed. Thus, we performed coil embolization. After interventional radiography (IVR), magnetic resonance imaging and endoscopic retrograde pancreatography showed a branch duct IPMN. Based on these findings, elective laparoscopic distal pancreatectomy was performed. The histopathological diagnosis was IPMN with HP caused by rupture of a splenic artery aneurysm. For such complicated cases, minimally invasive surgery is applicable after successful hemostasis by IVR.
Keyphrases
- computed tomography
- low grade
- magnetic resonance imaging
- coronary artery
- rare case
- healthcare
- minimally invasive
- robot assisted
- emergency department
- chronic pain
- high grade
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- abdominal aortic aneurysm
- positron emission tomography
- case report
- contrast enhanced
- image quality
- pain management
- neuropathic pain
- spinal cord
- dual energy