Author/Editor		D'Onofrio, Mirko; Mansueto, Giancarlo; Gasparini, Anna; Vasori, Simone; Falcon, Massimo; Procacci, Carlo
Title		Endovascular management of splanchnic arteries bleeding in pancreato-biliary disease
Translated title		Endovascularno zdravljenje krvavitve iz splanhnične arterije pri bolnikih z pankreatobiliarnim obolenjem
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 36, št. 4
Publication year		2002
Volume		str. 281-90
Language		eng
Abstract		Background. Splanchnic artery bleeding is a life-threatening condition, especially in high-risk patients. The purpose of this study is to evaluate the efficacy of endovascular treatment of splanchnic artery bleeding in pancreato-biliary disease, considered as survival at the 3-month follow-up. Patients and methods. From 1992 to 2001 39 patients with upper splanchnic arterial lesion due to acute and chronic pancreatitis after surgery or percutaneous procedures, or as a complication of aneurysms or trauma, were treated using endovascular techniques. The patients underwent CT control immediately after the procedure, after seven days and then at the 3, 6 and 12-month follow-up. Results. In some patients, more than one angiography was necessary to identify the source of bleeding. Bleeding was stopped in all treated patients. Fatal re-bleeding occurred in 6 patients and, in the first part of the study, 2 patients died of hepatic failure after hepatic artery embolization. Conclusions. Splanchnic artery bleeding is a life-threatening condition. Endovascular treatment can reach a clinical success rate of up to 75% at three months.
Summary		Izhodišča. Krvavitev iz splanhnične arterije je nevarno obolenje že zlasti pri možno ogroženih bolnikih. Z raziskavo smo nameravali oceniti učinkovitost endovaskularnega zdravljenja krvavitve iz splanhnične aterije pri bolnikih s pankreatobiliarnim obolenjem. Če so bolniki preživeli 3 mesece, smo smatrali, da je bil poseg uspešen. Bolniki in metode. Od 1992 do 2001 smo z endovaskularno metodo zdravili 39 bolnikov s poškodbo zgornje splanhnične arterije zaradi akutnega ali kroničnega vnetja trebušne slinavke, kirurškega zdravljenja oz. perkutanih posegov, zaradi zapletov ob anevrizmi ali poškodbi. Bolnike smo napotili na pregled z računalniško tomografijo takoj po posegu in nato še sedmi dan po posegu ter po 3, 6 in 12 mesecih. Rezultati. Pri nekaterih bolnikih je bilo potrebno angiografijo večkrat ponoviti, da smo lahko odkrili mesto krvavitve. Pri vseh bolnikih smo krvavitev zaustavili. Ponovljena krvavitev je bila pri 6 bolnikih usodna. V prvem raziskovalnem obdobju sta umrla 2 bolnika zaradi jetrne odpovedi po embolizaciji arterije. Zaključki. Krvavitev iz splanhnične arterije je zelo nevarno obolenje. Z endovaskularnim zdravljenjem lahko dosežemo do 75-odstotono preživetje po treh mesecih.
Descriptors		SPLANCHNIC CIRCULATION PANCREATITIS BILIARY TRACT DISEASES HEMORRHAGE EMBOLIZATION, THERAPEUTIC MESENTERIC ARTERIES LIVER CIRCULATION