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Bleeding pseudoaneurysms complicating upper abdominal surgery.

Hester Y S Cheung1, C N Tang, K H Fung

  • 1Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong. yui92549@yahoo.com

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|December 7, 2007
PubMed
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This summary is machine-generated.

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Ruptured pseudoaneurysms after upper abdominal surgery can be diagnosed and treated effectively with visceral angiography. This minimally invasive procedure offers a safe, first-line option with a low re-bleeding rate.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Gastrointestinal Surgery

Background:

  • Ruptured pseudoaneurysms are a rare but serious complication following major upper abdominal surgery.
  • Management options traditionally include open surgical repair and endovascular interventions.

Purpose of the Study:

  • To review the management of ruptured pseudoaneurysms in patients who underwent major upper abdominal surgery.
  • To evaluate the efficacy and safety of visceral angiography as a primary treatment modality.

Main Methods:

  • A retrospective study was conducted at a minimal access surgery center.
  • Eight patients diagnosed with pseudoaneurysms post-upper abdominal surgery between 1998 and 2006 were included.
  • Outcomes assessed included hemostasis success rate, re-bleeding, re-intervention, and mortality.

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Main Results:

  • Visceral angiography identified the bleeding source in most cases, achieving hemostasis without re-bleeding.
  • Embolization demonstrated an 80% success rate and 0% re-bleeding rate.
  • Open surgery had a 67% success rate but a 33% re-bleeding rate; overall mortality was 20%.

Conclusions:

  • Visceral angiography is a safe and effective first-line intervention for ruptured pseudoaneurysms complicating upper abdominal surgery.
  • It allows for diagnosis and treatment in a single session with a low re-bleeding rate.
  • Angiography is as effective as alternative treatments and should be considered the primary approach.