Transarterial Embolization of Ruptured Pancreaticoduodenal Artery Pseudoaneurysm Related to Chronic Pancreatitis.
Lucian MărgineanAdrian Vasile MureșanEmil-Marian ArbănaşiCătălin Mircea CoșarcăAlexandra-Cristina MunteanuEliza RussuRares Cristian FilepRéka KallerPublished in: Diagnostics (Basel, Switzerland) (2023)
We presented a 67-year-old woman with lightheadedness, diaphoresis, and acute epigastric and right hypochondrium pain, with a past medical history including stage 2 essential hypertension, chronic ischemic cardiomyopathy, and class 1 obesity. An abdominal contrast-enhanced CT scan showed an extensive hematoma (3 × 4 cm 2 in size) located intra-abdominally, adjacent to the duodenojejunal area, with hyperdensity around the duodenum, positioned inferior to the pancreas (30-59 HU). Moreover, the CT scan also revealed an enhancing lesion as a pseudoaneurysm of the inferior pancreaticoduodenal artery, measuring 5 × 8 × 8 mm 3 with active bleeding and associated hematoma. Following these investigations of the abdominal area, a decision was made to proceed with an endovascular intervention within the interventional radiology department. With the patient under conscious sedation, via a right common femoral artery approach, the superior mesenteric artery was catheterized. While injecting the contrast agent to obtain a better working projection, the pseudoaneurysm ruptured, and acute extravasation of the contrast agent was noted, followed by injection of a mixture of 1 mL Glubran 2 with 2 mL Lipiodol until complete obliteration of the pseudoaneurysm was obtained. The patient was hemodynamically stable at the end of the procedure and was discharged 6 days later in a good condition without active bleeding signs.
Keyphrases
- contrast enhanced
- computed tomography
- endovascular treatment
- diffusion weighted
- magnetic resonance imaging
- magnetic resonance
- dual energy
- liver failure
- image quality
- diffusion weighted imaging
- drug induced
- blood pressure
- case report
- atrial fibrillation
- positron emission tomography
- aortic dissection
- randomized controlled trial
- heart failure
- metabolic syndrome
- healthcare
- subarachnoid hemorrhage
- chronic pain
- type diabetes
- brain injury
- ischemia reperfusion injury
- body mass index
- weight gain
- spinal cord
- hepatitis b virus
- single cell
- neuropathic pain
- cerebral ischemia
- weight loss
- pain management
- abdominal aortic aneurysm