Rakuhei Nakama, T. Yagami, I. Kono, Kazuki Arakawa, Koki Usui, Koki Kato, Keiichi Tanimura, M. Honda
{"title":"Outflow of N-butyl-2-cyanoacrylate into the Pancreatic Duct: Transcatheter Arterial Embolization for Hemosuccus Pancreaticus","authors":"Rakuhei Nakama, T. Yagami, I. Kono, Kazuki Arakawa, Koki Usui, Koki Kato, Keiichi Tanimura, M. Honda","doi":"10.22575/interventionalradiology.2020-0002","DOIUrl":null,"url":null,"abstract":"A 54-year-old Japanese woman, hospitalized for recurrent chronic alcoholic pancreatitis, manifested bloody stools. An esophagogastroduodenoscopy revealed active bleeding from the papilla of Vater. Contrast-enhanced computed tomography (CECT) revealed a pseudoaneurysm in the pancreatic pseudocyst (hemosuccus pancreaticus). Angiography demonstrated pseudoaneurysm of the dorsal pancreatic artery branch. We selected N-butyl-2-cyanoacrylate (NBCA) as an embolus material because of the existing coagulopathy and difficulty in selecting the arterial branch. The administered NBCA outflowed into the pancreatic duct over the pseudoaneurysm. However, transcatheter arterial embolization (TAE) was successful, and no complication or rebleeding was observed after TAE. CECT showed NBCA cast in the pancreatic duct; however, the chronic pancreatitis improved. NBCA may be used to regulate hemosuccus pancreaticus in emergency settings; however, interventional radiologists must carefully consider the complications caused by NBCA.","PeriodicalId":73503,"journal":{"name":"Interventional radiology (Higashimatsuyama-shi (Japan)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional radiology (Higashimatsuyama-shi (Japan)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22575/interventionalradiology.2020-0002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
A 54-year-old Japanese woman, hospitalized for recurrent chronic alcoholic pancreatitis, manifested bloody stools. An esophagogastroduodenoscopy revealed active bleeding from the papilla of Vater. Contrast-enhanced computed tomography (CECT) revealed a pseudoaneurysm in the pancreatic pseudocyst (hemosuccus pancreaticus). Angiography demonstrated pseudoaneurysm of the dorsal pancreatic artery branch. We selected N-butyl-2-cyanoacrylate (NBCA) as an embolus material because of the existing coagulopathy and difficulty in selecting the arterial branch. The administered NBCA outflowed into the pancreatic duct over the pseudoaneurysm. However, transcatheter arterial embolization (TAE) was successful, and no complication or rebleeding was observed after TAE. CECT showed NBCA cast in the pancreatic duct; however, the chronic pancreatitis improved. NBCA may be used to regulate hemosuccus pancreaticus in emergency settings; however, interventional radiologists must carefully consider the complications caused by NBCA.