Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy
Postpancreatectomy hemorrhage is one of the major life-threatening complications of pancreatic surgery. Radiological intervention is used as a first-line approach for the initial treatment of late arterial hemorrhage. However, rehemorrhage has a high risk for mortality, and it is undecided which urg...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2019-02-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | https://www.karger.com/Article/FullText/496918 |
| _version_ | 1819057385093726208 |
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| author | Kenji Mimatsu Nobutada Fukino Hisao Kano Atsushi Kawasaki Takatsugu Oida |
| author_facet | Kenji Mimatsu Nobutada Fukino Hisao Kano Atsushi Kawasaki Takatsugu Oida |
| author_sort | Kenji Mimatsu |
| collection | DOAJ |
| description | Postpancreatectomy hemorrhage is one of the major life-threatening complications of pancreatic surgery. Radiological intervention is used as a first-line approach for the initial treatment of late arterial hemorrhage. However, rehemorrhage has a high risk for mortality, and it is undecided which urgent intervention provides optimal management for rehemorrhage. We experienced a successful surgical laparotomy for the repeated delayed arterial hemorrhage caused by a pancreaticoduodenectomy (PD) for chronic pancreatitis. A 57-year-old man had undergone PD with pancreaticogastrostomy for tumor-forming pancreatitis with possible pancreatic cancer. A delayed massive hemorrhage from the drain developed 11 days after surgery. Although angiography was done, the bleeding site was not clearly detected. Therefore, urgent surgical laparotomy was performed. Arterial bleeding was detected from the stump of the gastroduodenal artery. Surgical ligation, using the suture technique, was performed for hemostasis, and a closed drain was placed in the area due to drainage of pancreatic juice and an abscess. However, rehemorrhage from the drain developed 7 days after the initial hemorrhage. Relaparotomy was performed immediately. The surgical ligation and compression hemostasis with absorbable hemostatic cotton was done. After relaparotomy for rehemorrhage, there was no hemorrhage or fatal hepatic failure. He left our hospital 64 days after initial surgery. Surgical laparotomy is one of the feasible procedures for hemostasis of a massive arterial hemorrhage. Proper blood vessel ligation is necessary for reliable hemostasis and proper drainage of pancreatic juice and abscesses to prevent hemorrhage. |
| first_indexed | 2024-12-21T13:38:28Z |
| format | Article |
| id | doaj.art-a2b630fd944945d4ac9912680a06b184 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-21T13:38:28Z |
| publishDate | 2019-02-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-a2b630fd944945d4ac9912680a06b1842022-12-21T19:02:05ZengKarger PublishersCase Reports in Gastroenterology1662-06312019-02-01131505710.1159/000496918496918Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after PancreaticoduodenectomyKenji MimatsuNobutada FukinoHisao KanoAtsushi KawasakiTakatsugu OidaPostpancreatectomy hemorrhage is one of the major life-threatening complications of pancreatic surgery. Radiological intervention is used as a first-line approach for the initial treatment of late arterial hemorrhage. However, rehemorrhage has a high risk for mortality, and it is undecided which urgent intervention provides optimal management for rehemorrhage. We experienced a successful surgical laparotomy for the repeated delayed arterial hemorrhage caused by a pancreaticoduodenectomy (PD) for chronic pancreatitis. A 57-year-old man had undergone PD with pancreaticogastrostomy for tumor-forming pancreatitis with possible pancreatic cancer. A delayed massive hemorrhage from the drain developed 11 days after surgery. Although angiography was done, the bleeding site was not clearly detected. Therefore, urgent surgical laparotomy was performed. Arterial bleeding was detected from the stump of the gastroduodenal artery. Surgical ligation, using the suture technique, was performed for hemostasis, and a closed drain was placed in the area due to drainage of pancreatic juice and an abscess. However, rehemorrhage from the drain developed 7 days after the initial hemorrhage. Relaparotomy was performed immediately. The surgical ligation and compression hemostasis with absorbable hemostatic cotton was done. After relaparotomy for rehemorrhage, there was no hemorrhage or fatal hepatic failure. He left our hospital 64 days after initial surgery. Surgical laparotomy is one of the feasible procedures for hemostasis of a massive arterial hemorrhage. Proper blood vessel ligation is necessary for reliable hemostasis and proper drainage of pancreatic juice and abscesses to prevent hemorrhage.https://www.karger.com/Article/FullText/496918LaparotomyDelayed arterial hemorrhagePancreaticoduodenectomy |
| spellingShingle | Kenji Mimatsu Nobutada Fukino Hisao Kano Atsushi Kawasaki Takatsugu Oida Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy Case Reports in Gastroenterology Laparotomy Delayed arterial hemorrhage Pancreaticoduodenectomy |
| title | Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy |
| title_full | Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy |
| title_fullStr | Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy |
| title_full_unstemmed | Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy |
| title_short | Surgical Laparotomy for Repeated Delayed Arterial Hemorrhage after Pancreaticoduodenectomy |
| title_sort | surgical laparotomy for repeated delayed arterial hemorrhage after pancreaticoduodenectomy |
| topic | Laparotomy Delayed arterial hemorrhage Pancreaticoduodenectomy |
| url | https://www.karger.com/Article/FullText/496918 |
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