Delayed Hemorrhage from Gastroduodenal Artery Pseudoaneurysm following Endoscopic Ultrasound-Guided Fine Needle Aspiration of Pancreatic Head Mass.
10.15279/kpba.2018.23.4.165
- Author:
Young Jae DOO
1
;
Seung Goun HONG
Author Information
1. Department of Internal Medicine, SAM Anyang Hospital, Anyang, Korea. permi@naver.com
- Publication Type:Case Report
- Keywords:
Gastrointestinal hemorrhage;
Pancreatic neoplasm;
Endoscopic ultrasound-guided fine needle aspiration;
Pseudoaneurysm;
Gastroduodenal artery
- MeSH:
Aged;
Aneurysm, False*;
Angiography;
Arteries*;
Diagnosis;
Embolization, Therapeutic;
Emergency Service, Hospital;
Endoscopic Ultrasound-Guided Fine Needle Aspiration*;
Gastrointestinal Hemorrhage;
Head*;
Hemorrhage*;
Hemostasis;
Humans;
Pancreatic Neoplasms;
Pancreaticoduodenectomy;
Pancreatitis;
Sepsis
- From:Korean Journal of Pancreas and Biliary Tract
2018;23(4):165-171
- CountryRepublic of Korea
- Language:English
-
Abstract:
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a well-established procedure for the diagnosis of pancreatobiliary disease. Serious complications such as perforation, pancreatitis, hemorrhage, and sepsis are rarely reported. To our knowledge, delayed hemorrhage after EUS-FNA is very rare and hemorrhage from iatrogenic pseudoaneurysm has yet to be reported. We report a case of delayed hemorrhage from gastroduodenal artery pseudoaneurysm, which developed after EUS-FNA of a solid pancreatic lesion. A 68-year-old man presented with tarry stool 10 days after EUS-FNA of a 1.5 cm-sized pancreatic head mass. Abdominal computed tomography showed a 2-cm-sized intensely enhancing round lesion near pancreatic head. EUS-FNA was negative for malignancy. The patient refused admission for further evaluation. Twelve days later, he reported to the emergency room with persistent tarry stool. Angiography showed a gastroduodenal artery pseudoaneurysm. Subsequent coil embolization resulted in successful hemostasis. The patient underwent pylorus-preserving pancreaticoduodenectomy and was diagnosed with stage IIB pancreatic cancer.
