Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis

Hemorrhagic pseudocyst (HP) and pseudocyst-associated pseudoaneurysms (PPs) are complications of pseudocyst. Angiography with embolization has been advocated as the first-line intervention for HP. A 47-year-old man with groove pancreatitis combined with HP near the pancreatic head was treated conser...

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Main Authors: Gwang Mo Kim, Soon Young Ko, Joon Ho Wang
Format: Article
Language:English
Published: Karger Publishers 2020-04-01
Series:Case Reports in Gastroenterology
Subjects:
Online Access:https://www.karger.com/Article/FullText/502836
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author Gwang Mo Kim
Soon Young Ko
Joon Ho Wang
author_facet Gwang Mo Kim
Soon Young Ko
Joon Ho Wang
author_sort Gwang Mo Kim
collection DOAJ
description Hemorrhagic pseudocyst (HP) and pseudocyst-associated pseudoaneurysms (PPs) are complications of pseudocyst. Angiography with embolization has been advocated as the first-line intervention for HP. A 47-year-old man with groove pancreatitis combined with HP near the pancreatic head was treated conservatively. He had relapsed pancreatitis with a newly identified pseudoaneurysm; however, the pseudocyst size was reduced. Although pseudoaneurysm was identified, angiography was not performed because there was no evidence of ongoing bleeding, and he was in a stable condition. Sphincterotomy and stent insertion in the pancreatic duct was applied to prevent relapsed pancreatitis with facilitation of the flow of pancreatic juice. He has done well during the 10-month follow-up, without recurrent pancreatitis. Angiography as an initial approach in HP and PPs may need to be more selective depending on the clinical presentation of the patient. A lysed clot within the strictured pancreatic duct during the healing process has been thought to be the cause of relapsed pancreatitis, and pancreatic sphincterotomy and stent insertion should be the preferred treatment methods.
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spelling doaj.art-8118dc8dfb3c42e78f5d5baa9b08dd432022-12-22T01:28:57ZengKarger PublishersCase Reports in Gastroenterology1662-06312020-04-0114113113610.1159/000502836502836Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove PancreatitisGwang Mo KimSoon Young KoJoon Ho WangHemorrhagic pseudocyst (HP) and pseudocyst-associated pseudoaneurysms (PPs) are complications of pseudocyst. Angiography with embolization has been advocated as the first-line intervention for HP. A 47-year-old man with groove pancreatitis combined with HP near the pancreatic head was treated conservatively. He had relapsed pancreatitis with a newly identified pseudoaneurysm; however, the pseudocyst size was reduced. Although pseudoaneurysm was identified, angiography was not performed because there was no evidence of ongoing bleeding, and he was in a stable condition. Sphincterotomy and stent insertion in the pancreatic duct was applied to prevent relapsed pancreatitis with facilitation of the flow of pancreatic juice. He has done well during the 10-month follow-up, without recurrent pancreatitis. Angiography as an initial approach in HP and PPs may need to be more selective depending on the clinical presentation of the patient. A lysed clot within the strictured pancreatic duct during the healing process has been thought to be the cause of relapsed pancreatitis, and pancreatic sphincterotomy and stent insertion should be the preferred treatment methods.https://www.karger.com/Article/FullText/502836groove pancreatitishemorrhagic pseudocystpseudoaneurysm
spellingShingle Gwang Mo Kim
Soon Young Ko
Joon Ho Wang
Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
Case Reports in Gastroenterology
groove pancreatitis
hemorrhagic pseudocyst
pseudoaneurysm
title Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
title_full Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
title_fullStr Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
title_full_unstemmed Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
title_short Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis
title_sort spontaneous resolution of hemorrhagic pseudocyst associated pseudoaneurysm in groove pancreatitis
topic groove pancreatitis
hemorrhagic pseudocyst
pseudoaneurysm
url https://www.karger.com/Article/FullText/502836
work_keys_str_mv AT gwangmokim spontaneousresolutionofhemorrhagicpseudocystassociatedpseudoaneurysmingroovepancreatitis
AT soonyoungko spontaneousresolutionofhemorrhagicpseudocystassociatedpseudoaneurysmingroovepancreatitis
AT joonhowang spontaneousresolutionofhemorrhagicpseudocystassociatedpseudoaneurysmingroovepancreatitis