Skip to main content

Advertisement

SpringerLink
Log in

Percutaneous thrombin injection under sonographic guidance for exclusion of non-catheterizable post-pancreatitis pseudoaneurysm of the superior mesenteric artery: a minimally invasive and expeditious treatment option

  • Case Report
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Post-pancreatitis pseudoaneurysms are not uncommon. They have a high associated mortality due to a propensity to rupture. Current standards of treatment advocate immediate intravascular interventions. We describe two cases of alcohol-related post-acute pancreatitis pseudoaneurysms arising from the second-order branches of the superior mesenteric artery (SMA) that were endoluminally inaccessible. Both cases were successfully treated with percutaneous thrombin injection into the pseudoaneurysm sac under ultrasound guidance. We suggest that endoluminally inaccessible pseudoaneurysms that are percutaneously accessible can be expeditiously treated with percutaneous thrombin injection. Further, due to the efficaciousness of this procedure, it could be considered as a first-line minimally invasive therapeutic option.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hamel E, Parc A, Adda R, et al. Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis. Br J Surg. 1991;78:1059–63.

    Article  PubMed  Google Scholar 

  2. Tadao M, Yuji O. Role of free radicals in the development of severe acute pancreatitis. Nippon Rinsho. 2004;62:2015–20.

    PubMed  Google Scholar 

  3. Schwartz LB, Clark ET, Gewertz BL. Anastomotic and other pseudoaneurysms. In: Rutherford RB, editor. Vascular surgery. 5th ed. Philadelphia: Saunders; 2000. p. 752–63.

    Google Scholar 

  4. Manazer JR, Monzon JR, Dietz PA, et al. Treatment of pancreatic pseudoaneurysm with percutaneous transabdominal thrombin injection. J Vasc Surg. 2003;38:600–2.

    Article  PubMed  Google Scholar 

  5. Kresowik TF, Khoury MD, Miller BV, et al. A prospective study of the incidence and natural history of femoral vascular complications after percutaneous transluminal coronary angioplasty. J Vasc Surg. 1991;13:328–33.

    Article  CAS  PubMed  Google Scholar 

  6. Munera F, Soto JA, Palacio D, et al. Diagnosis of arterial injuries caused by penetrating trauma to the neck: comparison of helical CT angiography and conventional angiography. Radiology. 2000;216:356–62.

    Article  CAS  PubMed  Google Scholar 

  7. Saad NE, Saad WE, Davies MG, et al. Pseudoaneurysms and the role of minimally invasive techniques in their management. Radio Graph. 2005;25:S173–89.

    Google Scholar 

  8. Kang SS, Labropoulos N, Mansour MA, et al. Expanded indications for ultrasoundguided thrombin injection of pseudoaneurysms. J Vasc Surg. 2000;31:289–98.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. GB Pant Institute of Post Graduate Medical Education and Research Delhi, Delhi, India

    Udit Chauhan, Sunil Kumar Puri, Neeraj Jain, Lalit Garg, Abhay Kapoor, Nishant Gupta & Vandana Goel

Authors
  1. Udit Chauhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sunil Kumar Puri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Neeraj Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lalit Garg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abhay Kapoor
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nishant Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vandana Goel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Udit Chauhan.

Ethics declarations

Conflict of interest

Udit Chauhan, Sunil Puri, Neeraj Jain, Lalit Garg, Abhay Kapoor, Nishant Gupta, and Vandana Goel declare that there are no conflicts of interest.

Ethical consideration

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 [5]. Informed consent was obtained from all patients for being included in the study.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chauhan, U., Puri, S.K., Jain, N. et al. Percutaneous thrombin injection under sonographic guidance for exclusion of non-catheterizable post-pancreatitis pseudoaneurysm of the superior mesenteric artery: a minimally invasive and expeditious treatment option. J Med Ultrasonics 43, 295–299 (2016). https://doi.org/10.1007/s10396-015-0687-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-015-0687-4

Keywords

Search

Navigation