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Hemosuccus Pancreaticus in a Patient with Iodine Allergy: Successful Diagnosis with Magnetic Resonance Imaging and Treatment with Transarterial Embolization Using Carbon Dioxide as the Contrast Medium

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Abstract

Hemosuccus pancreaticus (HP) is defined as gastrointestinal bleeding via the pancreatic duct and duodenal papilla. Since the bleeding is usually intermittent, it often remains undetected by endoscopy. Most cases are diagnosed by contrast-enhanced computed tomography (CT) or angiography, and the first-line treatment is transarterial embolization (TAE). However, in general, these modalities require a large amount of iodinated contrast medium. Here, we report the case of a 50-year-old female with HP due to chronic pancreatitis. Contrast-enhanced CT and ordinary angiography were contraindicated for her, as she was allergic to iodine. She was diagnosed with HP following gadolinium-enhanced magnetic resonance imaging and successfully treated by TAE of the splenic artery with metallic coils using carbon dioxide as the contrast medium.

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Authors and Affiliations

  1. Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ward, Tokyo, 113-8655, Japan

    Soichiro Miki & Toshihiro Furuta

  2. Department of Diagnostic and Interventional Radiology, Tsukuba University Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan

    Kensaku Mori, Shiigai Masanari, Tsukasa Saida, Eriko Tohno & Manabu Minami

  3. Department of Radiology, Kanto Medical Center NTT EC, 5-9-22 Higashi-gotanda, Shinagawa-ward, Tokyo, 141-8625, Japan

    Makiko Hiratsuka

Authors
  1. Soichiro Miki
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  2. Kensaku Mori
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  3. Shiigai Masanari
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  4. Toshihiro Furuta
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  5. Tsukasa Saida
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  6. Makiko Hiratsuka
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  7. Eriko Tohno
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  8. Manabu Minami
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Correspondence to Soichiro Miki.

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Miki, S., Mori, K., Masanari, S. et al. Hemosuccus Pancreaticus in a Patient with Iodine Allergy: Successful Diagnosis with Magnetic Resonance Imaging and Treatment with Transarterial Embolization Using Carbon Dioxide as the Contrast Medium. Cardiovasc Intervent Radiol 32, 1296–1299 (2009). https://doi.org/10.1007/s00270-008-9488-0

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  • DOI: https://doi.org/10.1007/s00270-008-9488-0

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