E-ISSN 1305-3612
Interventional Radiology - Case Report 2016
Angiographic embolization of arterial hemorrhage following endoscopic US-guided cystogastrostomy for pancreatic pseudocyst drainage
1 From the Medical School University of Virginia, Charlottesville, VA, USA  
2 Department of Radiology, University of Virginia, Charlottesville, VA, USA  
3 Department of Radiology (M.K. *), Gülhane Military Medical Academy, Ankara, Turkey.  
4 Department of Gastroenterology (P.Y.), University of Virginia, Charlottesville, VA, USA  
Diagn Interv Radiol 2008; 14: 57-60

Key Words: pancreatic pseudocyst • endoscopy • hemorrhage • ultrasonography
Abstract

Pseudocyst development is a common complication of chronic pancreatitis. Endoscopic cystogastrostomy is an alternative to percutaneous drainage of pancreatic pseudocysts. Endoscopic ultrasound (EUS) guidance is thought to decrease the procedural risk by identifying and avoiding intervening vasculature. With EUS guidance, extreme care should be exercised to identify large gastric vessels in the path of the puncture. Preoperative imaging should be closely scrutinized for the presence of these vessels. In cases of hemorrhage, balloon tamponading is a rapid way to provide temporary control, allowing transfer of the patient for angiographic embolization. We present a case of arterial hemorrhage due to inadvertent puncture of a hypertrophied right gastric artery following EUS-guided cystogastrostomy, which was successfully treated with temporary balloon occlusion and coil embolization.

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