Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.012517
Jornal Vascular Brasileiro
Case Report

Endovascular treatment of pseudoaneurysms secondary to chronic pancreatitis: reports of two cases

Tratamento endovascular de pseudoaneurisma decorrente de pancreatite crônica: relato de dois casos

Fabiana Seifert Santos, Karolaine Marcelina da Silva Sousa, Thiago Augusto Cadorin de Castro, Felipe Coelho Neto, Rodrigo Gomes de Oliveira, Walter Jr. Boim de Araujo, Lilian Cabral Pereira dos Santos, Raquel Canzi Almada de Souza

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Resumo

Pseudoaneurysm secondary to chronic pancreatitis is a rare complication, but one with a high mortality rate. It is etiologically associated with chronic pancreatitis, and most diagnoses are made after rupture, which manifests with clinical signs of acute hemorrhage. Computed tomography plays an important role in diagnosis, but digital subtraction angiography remains the gold-standard method for diagnostic confirmation and for treatment planning. This article describes two cases of pseudoaneurysm in patients with chronic alcoholic pancreatitis; one involving the splenic artery and the other the gastroduodenal artery, complicated by thoracic and abdominal bleeding respectively. Both were successfully treated, using minimally invasive endovascular methods to implant coils and stent-grafts.

Palavras-chave

pseudoaneurysm of the splenic artery; chronic pancreatitis; alcoholic pancreatitis; arteriography; endovascular surgery.

Abstract

O pseudoaneurisma decorrente de pancreatite crônica consiste em complicação rara, porém com alta taxa de mortalidade. Está etiologicamente associado à pancreatite crônica, e seu diagnóstico é feito mais comumente após ruptura, manifestando-se através de sinais clínicos de hemorragia aguda. A tomografia computadorizada desempenha papel importante no diagnóstico; contudo, a angiografia por subtração digital mantém-se como método padrão-ouro para confirmação diagnóstica e direcionamento do tratamento. O presente artigo relata dois casos de pseudoaneurisma em pacientes com pancreatite crônica alcoólica, sendo um da artéria esplênica e outro da artéria gastroduodenal, complicados com sangramento torácico e abdominal respectivamente. Ambos foram submetidos a tratamento endovascular minimamente invasivo com sucesso, através de implante de molas e de stent-grafts.

Keywords

pseudoaneurisma de artéria esplênica; pancreatite crônica; pancreatite alcoólica; arteriografia; cirurgia endovascular.

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