Korean Journal of Gastrointestinal Endoscopy 2010;41(1): 31-35.
유문부 보존 췌십이지장 절제술 환자에서 발견이 어려웠던 가성동맥류를 내시경적 금속클립 유도하에 색전술을 시행한 1예
김용훈ㆍ권창일ㆍ주세경ㆍ김원희ㆍ빈홍건ㆍ김만득ㆍ황성규
CHA 의과학대학교 분당차병원 소화기센터
A Case of Successful Embolization with Superselection by Endoscopic Hemoclipping for Pseudoaneurysmal Bleeding in a Patient with Pylorus Preserving Pancreaticoduodenectomy
Yong Hun Kim, M.D., Chang-Il Kwon, M.D., Sae Kyung Joo, M.D., Won Hee Kim, M.D., Hong Gern Bin, M.D., Man Deuk Kim, M.D. and Seong Gyu Hwang, M.D.
Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Abstract
Arterial bleeding after pancreaticoduodenectomy is a very serious complication with high mortality. Therefore, early diagnosis and treatment is essential. In particular, early detection and immediate embolization can be effectively used for the delayed massive bleeding that occurs from a pseudoaneurysmal rupture. However, sometimes intermittent bleeding or a vessel spasm can cause the bleeding focus to remain unidentified in spite of repeated angiography. We experienced a case of successful embolization with superselection by endoscopic hemoclipping in a patient who underwent pylorus preserving pancreaticoduodenectomy, and the patient's bleeding focus was not found after repeated angiography. Endoscopic hemoclip application can be useful for localizing a pseudoaneurysmal rupture in patients with pancreaticoduodenectomy. (Korean J Gastrointest Endosc 2010;41:31-35)
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