Medline ® Abstract for Reference 5
of 'Overview of the complications of chronic pancreatitis'
Evidence for a central role for selective mesenteric angiography in the management of the major vascular complications of pancreatitis.
Beattie GC, Hardman JG, Redhead D, Siriwardena AK
Am J Surg. 2003;185(2):96.
BACKGROUND: Although mesenteric angiography and embolization are established radiologic procedures, the evidence-base to aid decision making regarding selection of these procedures in the emergent situation in patients with hemorrhagic complications of pancreatitis is limited.
METHODS: A retrospective analysis of 19 patients with hemorrhagic complications of pancreatic inflammatory disease (acute pancreatitis, chronic pancreatitis, and pseudocyst) referred over a 4-year period and identified at the point of mesenteric angiography in order to determine the influence of interventional radiologic maneuvers on outcome.
RESULTS: Mesenteric angiography localized bleeding in 15 (79%), with 11 (58%) embolizations undertaken. There was one (9%) procedure-related complication and 3 (27%) rebleeds. Of 11 patients undergoing embolization, 8 (73%) required no further intervention for bleeding and 8 (73%) survived.
CONCLUSIONS: Mesenteric angiography is valuable in localizing bleeding in patients with major vascular complications of pancreatic inflammatory disease. Angiographic embolization can achieve definitive hemostasis and stabilize a critically ill patient to permit disease reappraisal.
Department of Surgical and Clinical Sciences, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.