K. Dirks et al., An uncommon cause of gastrointestinal bleeding: Pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis, Z GASTROENT, 37(6), 1999, pp. 489-493
Pseudoaneurysm of the peripancreatic arteries is a typical cause of gastroi
ntestinal bleeding (GIB) in patients with chronic pancreatitis. 1-10% of ch
ronic pancreatitis are associated with an a pseudoaneurysm, especially of t
he splenic or gastroduodenal artery. Endoscopy often is not successful in f
inding the cause of bleeding. Sonography: especially color Doppler ultrasou
nd is the best diagnostic tool, indicating the need for celiac angiography.
We report on a 59-year-old woman with recurrent severe GIB since 1995. In
1998 another bleeding occurred and sonography showed a pseudoaneurysm of th
e gastroduodenal artery. Typical criteria are an echofree: pulsatile lesion
with an ring-like border. Color Doppler proves a turbulent perfusion insid
e and shows the feeding vessel. A transcatheter embolization with stainless
steel coils was successful, Sis months later the pseudoaneurysm was mainly
obliterated.