Transcatheter embolization as primary treatment for visceral pseudoaneurysms in pancreatitis: clinical outcome and imaging follow up.

ABSTRACT

BACKGROUND: Pseudoaneurysm formation is an uncommon but fatal complication of pancreatitis. The morbidity and mortality associated with surgical management is high. Transcatheter embolization is a definitive minimally invasive form of treatment. AIM: To review our experience with transcatheter embolization as a therapeutic modality for pseudoaneurysms complicating pancreatitis. METHODS: This retrospective analysis included data of 30 patients (mean age 37 years, range 25 to 65; 24 men) with visceral pseudoaneurysms secondary to pancreatitis, who underwent diagnostic angiography and transcatheter embolization, during the period March 1993 to February 2003. RESULTS: In 29 patients the pseudoaneurysms were successfully isolated from the circulation, and hemostasis was achieved. Re-bleeding occurred in one patient, for which re-embolization was done. Twenty-nine patients improved clinically. One patient in whom the pseudoaneurysm was successfully embolized died due to septicemic shock. CONCLUSION: Endovascular embolization is a safe and effective non-surgical modality of treatment for visceral pseudoaneurysms complicating pancreatitis.