Pancreatic and peripancreatic vessels: embolization for control of bleeding in pancreatitis.

Abstract

Bleeding associated with pancreatitis has a high mortality rate. Angiographic demonstration of uncontrollable bleeding or large pseudoaneurysms is an indication for emergency surgery. We have encountered a group of patients with obvious clinical gastrointestinal hemorrhage out of proportion to angiographic findings. Vessel abnormalities included areas of encasement, small pseudoaneurysms, and occasional extravasation without a clearly defined source. With the high risk of mortality in such patients, embolization is a viable method of therapy. Three patients are described who had different angiographic presentations and in whom hemorrhage was safely controlled with embolic therapy using nonpermanent occlusive materials.