Peripancreatic pseudoaneurysm after pancreatitis:An analysis of diagnosis and treatment of 10 cases

ZHOU Shu-yi; HUANG Geng-wen; SHEN Ding-cheng

doi:10.19538/j.cjps.issn1005-2208.2017.07.23

Abstract：Objective To investigate the early diagnosis and therapeutic options of peripancreatic pseudoaneurysm after pancreatitis. Methods The clinical data of 10 cases of peripancreatic pseudoaneurysm after acute pancreatitis or chronic pancreatitis admitted between January 2010 and August 2016 in Xiangya Hospital,Central South University were analyzed retrospectively. The 10 cases of pseudoaneurysm included 4 cases of pseudoaneurysm originated from splenic artery,2 from superior pancreatic-duodenal artery,2 from branches of superior mesenteric artery,1 from gastroduodenal artery and 1 from left gastric artery. All the cases were followed up for 13.4(4-74)months. Results The diagnostic accuracy rate of preoperative CT scan and angiography (DSA) were 30%and 100%respectively. The initial treatments included interventional radiologic embolization (7 cases) and surgeries (including 2 cases of distal pancreatectomy,resection of the splenic artery pseudoaneurysm,splenectomy and resection of splenic flexure and 1 cases of left gastric artery ligation and internal drainage of pancreatic pseudocyst). The in-hospital fatality rate was 60%. The death causes included 2 cases of MODS,2 cases of re-bleeding and 2 cases of infected pancreatic necrosis. Conclusion Early diagnosis is the key to improve the outcome of the pseudoaneurysm in the setting of pancreatitis. Interventional radiologic embolization and surgical operation are the main treatment methods. However,due to the individualization of the pancreatitis,the management of the pseudoaneurysm should also be individualized.