0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Management of Bleeding Pseudoaneurysms After Pancreatoduodenectomy

Takanori Yoshida, MD; Shigeo Ninomiya, MD; Takashi Matsumata, MD
Arch Surg. 2003;138(4):458. doi:10.1001/archsurg.138.4.458-a.
Text Size: A A A
Published online

Extract

We read with interest the article by Otah et al1 about bleeding visceral pseudoaneurysms following pancreatoduodenectomy. We agree that angiography has diagnostic value in patients with "sentinel" bleeding after pancreatic surgery. Identifying the source of the bleeding is essential for accurate treatment. It is our policy to attempt early angiography as soon as sentinel bleeding has been recognized. With the recent advances in interventional radiology, angiographic embolization has been used to treat arterial hemorrhage following pancreatoduodenectomy.2 Because of the risk of recurrent bleeding and/or uncontrolled intra-abdominal sepsis, a surgical approach consisting of proximal and distal suture ligation of the involved artery, drainage of septic collection, and repair of anastomotic leakage or completion of total pancreatectomy must be attempted, even in critically ill patients. However, embolization does allow temporary control of massive hemorrhage and decrease the need for high-risk emergency surgery.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();