This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal

Case Reports and a Review of the Literature

Thomas R. Gadacz, MD; Donald Trunkey, MD; Richard F. Kieffer, Jr, MD

Arch Surg. 1978;113(12):1438-1440.

Abstract
• Visceral artery erosion is an uncommon but disasterous complication of pancreatitis. When gastrointestinal bleeding or severe intra-abdominal hemorrhage is associated with pancreatitis and the usual sources of bleeding are not detected by endoscopy or barium studies, erosion of a visceral vessel should be suspected. We present nine cases and an additional 44 cases from previous reports are reviewed. A palpable abdominal mass was present in 59% of the patients; however, a pseudocyst was present in 78%. Arteriography was performed in 15 patients and the source of bleeding was evident in 14. The splenic artery was the most common site of bleeding, although the other branches of the celiac axis and the middle colic artery have been involved. Successful treatment consisted of ligation of the bleeding vessel and, if present, drainage of the pseudocyst. Depending on the location of the vessel and the pseudocyst, major resections may be necessary. When bleeding and the pancreatic inflammatory process involved the colon, ligation of the bleeding site, drainage of the area, and colostomy was the most successful form of treatment.

(Arch Surg 113:1438-1440, 1978)

Author Affiliations
From the Surgical Service, Loch Raven Veterans Administration Hospital, Baltimore (Drs Gadacz and Kieffer); the Johns Hopkins University School of Medicine, Baltimore (Drs Gadacz and Kieffer); and the San Francisco General Hospital (Dr Trunkey).

Footnotes
Accepted for publication July 6, 1978.

Reprint requests to Veterans Administration Hospital (151), 3900 Loch Raven Blvd, Baltimore, MD 21218 (Dr Gadacz).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Management of Delayed Postoperative Hemorrhage After Pancreaticoduodenectomy: A Meta-analysis
Limongelli et al.
Arch Surg 2008;143:1001-1007.
ABSTRACT | FULL TEXT  

Blood in the Belly: CT Findings of Hemoperitoneum
Lubner et al.
RadioGraphics 2007;27:109-125.
ABSTRACT | FULL TEXT  

Pancreaticoduodenal Artery Aneurysms: A Report of Two Cases and Review of the Literature
Eldar et al.
VASC ENDOVASCULAR SURG 1998;32:97-104.
ABSTRACT  

Arterial Embolization for Bleeding Pseudocysts Complicating Chronic Pancreatitis
Gambiez et al.
Arch Surg 1997;132:1016-1021.
ABSTRACT  

Multidisciplinary Approach to Pseudoaneurysms Complicating Pancreatic Pseudocysts: Impact of Pretreatment Diagnosis
Marshall et al.
Arch Surg 1996;131:278-283.
ABSTRACT  

Massive Rectal Bleeding From Colonic Fistula in Pancreatitis
Poole and Wallenhaupt
Arch Surg 1984;119:732-735.
ABSTRACT  

Reduced Mortality From Bleeding Pseudocysts and Pseudoaneurysms Caused by Pancreatitis
Stabile et al.
Arch Surg 1983;118:45-51.
ABSTRACT