Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report
The patient was a man in his 60s who previously underwent placement of covered stents in the duodenum for a duodenal stricture caused by pancreatic cancer invasion. He experienced multiple episodes of hematemesis and hematochezia during hospitalization. Emergency upper and lower gastrointestinal end...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S193004332300448X |
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| author | Kodai Fukuda, MD Tetsuo Sonomura, MD, PhD Nobuyuki Higashino, MD Ryosuke Mimura, MD Hiroki Furotani, MD Ryota Tanaka, MD, PhD Takao Koyama, MD Hirotatsu Sato, MD, PhD Akira Ikoma, MD, PhD Yasunobu Yamashita, MD, PhD Masayuki Kitano, MD, PhD Hiroki Minamiguchi, MD, PhD |
| author_facet | Kodai Fukuda, MD Tetsuo Sonomura, MD, PhD Nobuyuki Higashino, MD Ryosuke Mimura, MD Hiroki Furotani, MD Ryota Tanaka, MD, PhD Takao Koyama, MD Hirotatsu Sato, MD, PhD Akira Ikoma, MD, PhD Yasunobu Yamashita, MD, PhD Masayuki Kitano, MD, PhD Hiroki Minamiguchi, MD, PhD |
| author_sort | Kodai Fukuda, MD |
| collection | DOAJ |
| description | The patient was a man in his 60s who previously underwent placement of covered stents in the duodenum for a duodenal stricture caused by pancreatic cancer invasion. He experienced multiple episodes of hematemesis and hematochezia during hospitalization. Emergency upper and lower gastrointestinal endoscopies were performed but were unable to reveal the bleeding source. Based on these findings, we suspected small intestinal bleeding and emergency angiography was performed for the purpose of hemostasis. Computed tomography during arteriography was performed from the superior mesenteric artery and revealed extravasation outside the covered stents in the descending portion of the duodenum. Angiography of the inferior pancreaticoduodenal artery revealed extravasation in the descending portion of the duodenum, and the inferior pancreaticoduodenal artery was embolized with n-butyl cyanoacrylate. There were no postoperative symptoms indicative of intestinal ischemia or pancreatitis, and there was no rebleeding after embolization. In patients with bleeding outside the duodenal-covered stents, it can be difficult to identify the bleeding source by upper gastrointestinal endoscopy. In this case, selective computed tomography during arteriography and angiography revealed bleeding outside the duodenal-covered stents that was successfully treated by arterial embolization with n-butyl cyanoacrylate. |
| first_indexed | 2024-03-12T13:37:36Z |
| format | Article |
| id | doaj.art-b33d0d0c2b314065bae21ddfb2fd70e4 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-03-12T13:37:36Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-b33d0d0c2b314065bae21ddfb2fd70e42023-08-24T04:34:29ZengElsevierRadiology Case Reports1930-04332023-10-01181033953399Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case reportKodai Fukuda, MD0Tetsuo Sonomura, MD, PhD1Nobuyuki Higashino, MD2Ryosuke Mimura, MD3Hiroki Furotani, MD4Ryota Tanaka, MD, PhD5Takao Koyama, MD6Hirotatsu Sato, MD, PhD7Akira Ikoma, MD, PhD8Yasunobu Yamashita, MD, PhD9Masayuki Kitano, MD, PhD10Hiroki Minamiguchi, MD, PhD11Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 Japan; Corresponding author.Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanDepartment of Gastroenterology, Wakayama Medical University, Wakayama, JapanDepartment of Gastroenterology, Wakayama Medical University, Wakayama, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama Wakayama, 641-8509 JapanThe patient was a man in his 60s who previously underwent placement of covered stents in the duodenum for a duodenal stricture caused by pancreatic cancer invasion. He experienced multiple episodes of hematemesis and hematochezia during hospitalization. Emergency upper and lower gastrointestinal endoscopies were performed but were unable to reveal the bleeding source. Based on these findings, we suspected small intestinal bleeding and emergency angiography was performed for the purpose of hemostasis. Computed tomography during arteriography was performed from the superior mesenteric artery and revealed extravasation outside the covered stents in the descending portion of the duodenum. Angiography of the inferior pancreaticoduodenal artery revealed extravasation in the descending portion of the duodenum, and the inferior pancreaticoduodenal artery was embolized with n-butyl cyanoacrylate. There were no postoperative symptoms indicative of intestinal ischemia or pancreatitis, and there was no rebleeding after embolization. In patients with bleeding outside the duodenal-covered stents, it can be difficult to identify the bleeding source by upper gastrointestinal endoscopy. In this case, selective computed tomography during arteriography and angiography revealed bleeding outside the duodenal-covered stents that was successfully treated by arterial embolization with n-butyl cyanoacrylate.http://www.sciencedirect.com/science/article/pii/S193004332300448XDuodenal covered stentCT during arteriographyN-butyl cyanoacrylate |
| spellingShingle | Kodai Fukuda, MD Tetsuo Sonomura, MD, PhD Nobuyuki Higashino, MD Ryosuke Mimura, MD Hiroki Furotani, MD Ryota Tanaka, MD, PhD Takao Koyama, MD Hirotatsu Sato, MD, PhD Akira Ikoma, MD, PhD Yasunobu Yamashita, MD, PhD Masayuki Kitano, MD, PhD Hiroki Minamiguchi, MD, PhD Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report Radiology Case Reports Duodenal covered stent CT during arteriography N-butyl cyanoacrylate |
| title | Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report |
| title_full | Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report |
| title_fullStr | Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report |
| title_full_unstemmed | Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report |
| title_short | Duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization: A case report |
| title_sort | duodenal bleeding outside covered stents identified by selective computed tomography during arteriography that was successfully treated by embolization a case report |
| topic | Duodenal covered stent CT during arteriography N-butyl cyanoacrylate |
| url | http://www.sciencedirect.com/science/article/pii/S193004332300448X |
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