The clinical value of endovascular embolization in treating severe acute pancreatitis associated with hemorrhage / 介入放射学杂志

ABSTRACT

Objective To investigate the clinical value of endovascular embolization in treating severe acute pancreatitis (SAP) associated with hemorrhage. Methods The clinical data of 71 patients with SAP, who were admitted to authors' hospital during the period from 2010 to 2016, were collected. DSA was performed in all patients. Of the 71 patients, 27 (38.0％) received endovascular embolization treatment. The angiographic findings and the endovascular embolization results of the 27 patients were analyzed. Results Angiography demonstrated that 20 patients (28.2％, 20/71) had hemorrhage due to arterial rupture and 7 patients (9.9％, 7/71) had pseudoaneurysm formation. A total of 32 responsible arteries were detected, and the spleen artery was the main bleeding artery (34.4％, 11/32) . A total of 32 endovascular embolization procedures were carried out, the technical success rate was 93.8％ (30/32) . Post-embolization complication was seen in 4 patients, including infarction of spleen (n =2), which was improved after symptomatic treatment, liver abscess (n=1) and splenic abscess (n=1), which were improved after anti-infection therapy and tube drainage. Three patients died of hemorrhagic shock (n=2) or brain stem infarction (n=1), the causes of death were not related to the intervention operation. Five patients developed recurrent hemorrhage, in 4 of them the new bleeding point was different from the primary bleeding point, and successful hemostasis was achieved after second embolization treatment. Conclusion In treating SAP associated with hemorrhage, angiography together with endovascular embolization can quickly detect the hemorrhagic responsible arteries, thus, rapid hemostasis can be reliably achieved.