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World J Gastroenterol. Nov 21, 2014; 20(43): 16132-16137
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16132
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16132
Management of chronic pancreatitis complicated with a bleeding pseudoaneurysm
Kun-Chun Chiang, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Tsung-Hsing Chen, Department of Gastroenterology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Jun-Te Hsu, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Author contributions: Chiang KC and Hsu JT designed and performed research; Chiang KC and Hsu JT wrote the manuscript; all authors revised and approved the final edition of manuscript.
Correspondence to: Jun-Te Hsu, MD, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, No. 5, Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan 333, Taiwan. hsujt2813@adm.cgmh.org.tw
Telephone: +886-3-3281200-3219 Fax: +886-3-3285818
Received: February 25, 2014
Revised: June 8, 2014
Accepted: July 24, 2014
Published online: November 21, 2014
Revised: June 8, 2014
Accepted: July 24, 2014
Published online: November 21, 2014
Core Tip
Core tip: Chronic pancreatitis complicated with a bleeding pseudoaneurysm is a life-threatening condition. Therapeutic strategies for this rare disease remain controversial. In this review, surgical treatment as a first-line therapy is associated with a high mortality rate in emergency situations. Dynamic abdominal computed tomography and angiography should be performed as the initial management strategy to localize the bleeder, followed by embolization to control the bleeding to achieve early stabilization of the patient’s condition. Surgical intervention should be performed for patients who are unable to undergo or who fail arterial embolization for pseudoaneurysm bleeding, or when endoscopic management of the pseudocyst is unsuccessful.