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H Sasaki, Y Murakami, K Uemura, T Sudo, Y Hashimoto, N Kondo and T Sueda
Abstract
Postpancreatectomy hemorrhage is a potentially life-threatening complication. We report herein our experience with a 65-year-old man with locally advanced pancreatic adenocarcinoma who underwent pancreatoduodenectomy with lymphadenectomy following neoadjuvant chemoradiotherapy. On postoperative day 45, he developed massive hematemesis. Angiography revealed active bleeding from the common hepatic artery, and transcatheter coil embolization of that vessel was successfully performed. On postoperative day 64, he again developed massive hematemesis. Angiography revealed active bleeding from the proximal superior mesenteric artery. Immediately after coil embolization of that vessel, bypass grafting between the superior mesenteric artery and the right common iliac artery was performed, using a greater saphenous vein graft. The combination of embolization and bypass grafting is an option for treatment of bleeding from the superior mesenteric artery in an emergent situation.
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Concepts
Celiac artery, Abdominal aorta, Great saphenous vein, Superior mesenteric artery, Radiology, Blood, Coronary artery bypass surgery, Arteries of the abdomen
MeSH headings
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