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Titolo:
MANAGEMENT OF PANCREATICODUODENAL ARTERY ANEURYSMS PRESENTING AS CATASTROPHIC INTRAABDOMINAL BLEEDING
Autore:
NESCHIS DG; SAFFORD SD; GOLDEN MA;
Indirizzi:
HOSP UNIV PENN,34TH & SPRUCE ST PHILADELPHIA PA 19104 UNIV PENN,MED CTR,DEPT SURG PHILADELPHIA PA 19104
Titolo Testata:
Surgery
fascicolo: 1, volume: 123, anno: 1998,
pagine: 8 - 12
SICI:
0039-6060(1998)123:1<8:MOPAAP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCATHETER EMBOLIZATION; RUPTURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
D.G. Neschis et al., "MANAGEMENT OF PANCREATICODUODENAL ARTERY ANEURYSMS PRESENTING AS CATASTROPHIC INTRAABDOMINAL BLEEDING", Surgery, 123(1), 1998, pp. 8-12

Abstract

Background. Pancreaticoduodenal artery aneurysms (PDAs) are rare, accounting for only 2% of all visceral artery aneurysms. The majority of reported cases of patients with PDA have presented subsequent to rupture. Presentation without rupture also has been reported and is often associated with abdominal discomfort or diagnosed incidentally on radiologic studies. PDA rupture is associated with a high mortality rate, with fatal bleeding into the retroperitoneal space, intraperitoneal cavity, or gastrointestinal tract. Methods. This article reports two cases of ruptured PDA, both presenting as catastrophic intraabdominal bleeding and both treated successfully at celiotomy. In addition, the literature concerning PDA is reviewed. Results. Only 11 cases of PDA associated with sudden, severe abdominal pain and shock have been described. The mortality rate in these 11 cases was 36%, with half the patientsnot reaching the operating room alive. Successful management includesrapid resuscitation and control of the bleeding site with minimal pancreatic dissection, angiography for confirmation of vascular control and anatomic localization, and further definitive treatment if obliteration is incomplete. Conclusions. The aneurysm should be obliterated whenever possible to avoid both rebleeding and local complications related to mass effect such as pancreatic duct obstruction or erosion of the mass into neighboring structures. With appropriate and expeditious treatment, these gravely ill patients can be managed effectively and good outcomes obtained.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 12:19:41