Rare Cause of Delayed Upper Gastrointestinal Bleeding After Pancreaticoduodenectomy

Aneel Damle; Asa Clemenzi-Allen; Nicolas Jabbour; Shimul A Shah

doi:10.6092/1590-8577/480

Aneel Damle Solid Organ Transplantation, Department of Surgery, University of Massachusetts Medical School. Worcester, MA, USA
Asa Clemenzi-Allen
Nicolas Jabbour Solid Organ Transplantation, Department of Surgery, University of Massachusetts Medical School. Worcester, MA, USA
Shimul A Shah Solid Organ Transplantation, Department of Surgery, University of Massachusetts Medical School. Worcester, MA, USA

DOI: https://doi.org/10.6092/1590-8577/480

Keywords: Biliary Tract Surgical Procedures, Hemobilia, Hemorrhage, Jaundice, Pancreatic Neoplasms, Pancreatico¬duodenectomy

Abstract

Context Luminal bleeding after pancreaticoduodenectomy can be present in various degrees of acuity in up to 30% of patients. Case report In this report, we describe a rare and uncommon cause of gastrointestinal bleeding after pancreaticoduodenectomy and review of the literature. Conclusions Multiple biliary procedures with common complications increase the difficulty making the correct diagnosis and therefore all possible etiologies of a complication must be evaluated.

Downloads

Download data is not yet available.

References

Roulin D, Cerantola Y, Demartines N, Schäfer M. Systematic review of delayed postoperative hemorrhage after pancreatic resection. J Gastrointest Surg 2011; 15:1055-62.

Schäfer M, Heinrich S, Pfammatter T, Clavien PA. Management of delayed major visceral arterial bleeding after pancreatic surgery. HPB 2011; 13:132-8.

Limongelli P, Khorsandi SE, Pai M, Jackson JE, Tait P, Tierris J, Habib NA, Williamson RCN, Jiao LR. Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis. Arch Surg 2008; 143(10):1001-7.

Rumstadt B, Schwab M, Korth P, Samman M, Trede M. Hemorrhage after pancreatoduodenectomy. Ann Surg 2008; 227(2):236-41.

Choi SH, Moon HJ, Heo JS, Joh JW, Kim YI. Delayed hemorrhage after pancreaticoduodenectomy. J Am Coll Surg 2004; 199(2):186-91.

Rajarathinam G, Kannan DG, Vimalraj V, Amudhan A, Rajendran S, Jyotibasu D, et al. Post pancreaticoduodenectomy haemorrhage. HPB 2008; 10(5):363-70.

Yekebas EF, Wolfram L, Cataldegirmen G, Habermann CR, Bogoevski DR, Koenig AM, et al. Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in 1669 consecutive pancreatic resections. Ann Surg 2007; 246(2):269-80.

de Castro SM, Kuhlmann KF, Busch OR, van Delden OM, Laméris JS, van Gulik TM, et al. Delayed massive hemorrhage after pancreatic and biliary surgery embolization or surgery? Ann Surg 2005; 241(1):85-91.

Fujii Y, Shimada H, Endo I, Yoshida K, Matsuo K, Takeda K, et al. Management of massive arterial hemorrhage after pancreatobiliary surgery: does embolotherapy contribute to successful outcome? J Gastrointest Surg 2007; 11(4):32-438.

Treckmann J, Paul A, Sotiropoulos GC, Lang H, Özcelik, Saner AF, Broelsch CE. Sentinel bleeding after pancreaticoduodenectomy: a disregarded sign. J Gastrointest Surg 2008; 12(2):313-8.

Wente MN, Veit JA, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, et al. Postpancreatectomy haemorrhage (PPH) - an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery 2007; 142:20-25.

Ding X, Zhu J, Zhu M, Li C, Jian W, Jiang J, Wang Z, Hu S, Jiang X. Therapeutic management of hemorrhage from visceral artery pseudoaneurysms after pancreatic surgery. J Gastrointest Surg 2011; doi 10.1007/s11605-011-1561-3 [Online May 17, 2011]

Chin MW, Enns R. Hemobilia. Curr Gastroenterol Rep 2010; 12:121-9.

Burke DR, Lewis CA, Cardella JF, Citron SJ, Drooz AT, Haskal ZJ, et al. Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage. Society of cardiovascular and interventional radiology. J Vasc Interv Radiol 1997; 8(4):677-81.

Rivera-Sanfeliz GM, Assar OSA, LaBerge JM, Wilson MW, Gordon RL, Ring EJ, Kerlan RK. Incidence of Important Hemobilia following transhepatic biliary drainage: left-sided versus right-sided approaches. Cardiovasc Intervent Radiol 2004; 27:137-9.

Fidelman N, Bloom AI, Kerlan RK, LaBerge JM, Wilson MW, Ring EJ, Gordon RL. Hepatic arterial injuries after percutaneous biliary interventions in the era of laparoscopic surgery and liver transplantation: experience with 930 patients. Radiology 2006; 247(3):880-6.

Taneja M, Lo R, Sebastian MG, Chow PKH. Intra-hepatic arterial PSA causing life-threatening upper GI bleed after removal of biliary drainage catheter. Biomed Imaging Interv J 2009; 5(3):e20.