{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T02:32:07Z","timestamp":1746325927909},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hemorrhage due to a ruptured splanchnic pseudoaneurysm followed by the formation of a postoperative pancreatic fistula is the most severe complication of a pancreatectomy, sometimes leading to a fatal outcome. Stent graft placement to control the hemorrhage due to the pseudoaneurysm is a validated treatment option, but once the stent graft is infected, infection control is complicated. We report a case of a ruptured pseudoaneurysm of the splanchnic artery after pancreaticoduodenectomy to evaluate the stent graft treatment.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 77-year-old man underwent pylorus-preserving pancreaticoduodenectomy for suspected distal bile duct cancer. Hemorrhage from a pseudoaneurysm of the common hepatic artery due to the formation of the pancreatic fistula was detected on postoperative day 9, and a stent graft was successfully placed with the preservation of hepatic arterial blood flow. On postoperative day 12, new-onset hemorrhage from a pseudoaneurysm of the right hepatic artery developed, and a stent graft was similarly placed, but immediately occluded. Refractory pancreatic and biliary fistulas developed and required continuous drainage. On postoperative day 85, computed tomography revealed the presence of air within the latter stent graft, which indicated infection of the stent graft. The patient died due to sepsis caused by the graft infection.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Stent graft placement for the treatment of hemorrhage of a pseudoaneurysm secondary to a postoperative pancreatic fistula, following pancreaticoduodenectomy, is an effective treatment option as it achieves immediate hemostasis and maintains end-organ perfusion. However, stent graft infection is the most detrimental complication.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00887-w","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T16:03:55Z","timestamp":1591113835000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stent graft treatment for ruptured pseudoaneurysms of the splanchnic arteries after pancreaticoduodenectomy: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Masaru","family":"Nemoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midori","family":"Enokido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuyo","family":"Yoshimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,6,1]]},"reference":[{"key":"887_CR1","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1097\/01.sla.0000246856.03918.9a","volume":"244","author":"ML De Oliveira","year":"2006","unstructured":"De Oliveira ML, Winter JM, Schafer M, Cunningham SC, Cameron JL, Yeo CJ, et al. Assessment of complications after pancreatic surgery: a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 2006;244:931\u20137.","journal-title":"Ann Surg."},{"key":"887_CR2","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1002\/bjs.1800821124","volume":"82","author":"MI van Berge Henegouwen","year":"1995","unstructured":"van Berge Henegouwen MI, Allema JH, van Gulik TM, van Gulik TM, Verbeek PC, Obertop H, et al. Delayed massive haemorrhage after pancreatic and biliary surgery. Br J Surg. 1995;82:1527\u201331.","journal-title":"Br J Surg."},{"key":"887_CR3","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1007\/s00270-009-9502-1","volume":"32","author":"K Suzuki","year":"2009","unstructured":"Suzuki K, Mori Y, Komada T, Matsushima M, Ota T, Naganawa S. Stent-graft treatment for bleeding superior mesenteric artery pseudoaneurysm after pancreaticoduodenectomy. Cardiovasc Intervent Radiol. 2009;32:762\u20136.","journal-title":"Cardiovasc Intervent Radiol."},{"key":"887_CR4","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1097\/00000658-199802000-00013","volume":"227","author":"B Rumstadt","year":"1998","unstructured":"Rumstadt B, Schwab M, Korth P, Samman M, Trede M. Hemorrhage after pancreatoduodenectomy. Ann Surg. 1998;227:236\u201341.","journal-title":"Ann Surg."},{"key":"887_CR5","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.3748\/wjg.v16.i10.1239","volume":"16","author":"HG Lee","year":"2010","unstructured":"Lee HG, Heo JS, Choi SH, Choi DW. Management of bleeding from pseudoaneurysms following pancreaticoduodenectomy. World J Gastroenterol. 2010;16:1239\u201344.","journal-title":"World J Gastroenterol."},{"key":"887_CR6","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1245\/s10434-008-9894-1","volume":"15","author":"YW Tien","year":"2008","unstructured":"Tien YW, Wu YM, Liu KL, Ho CM, Lee PH. Angiography is indicated for every sentinel bleed after pancreaticoduodenectomy. Ann Surg Oncol. 2008;15:1855\u201361.","journal-title":"Ann Surg Oncol."},{"key":"887_CR7","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1001\/archsurg.143.10.1001","volume":"143","author":"P Limongelli","year":"2008","unstructured":"Limongelli P, Khorsandi SE, Pai M, Jackson JE, Tait P, Tierris J, et al. Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis. Arch Surg. 2008;143:1001\u20137.","journal-title":"Arch Surg."},{"key":"887_CR8","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1007\/s11605-011-1561-3","volume":"15","author":"X Ding","year":"2011","unstructured":"Ding X, Zhu J, Zhu M, Li C, Jian W, Jiang J, et al. Therapeutic management of hemorrhage from visceral artery pseudoaneurysms after pancreatic surgery. J Gastrointest Surg. 2011;15:1417\u201325.","journal-title":"J Gastrointest Surg."},{"key":"887_CR9","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s40792-015-0060-2","volume":"1","author":"S Fujioka","year":"2015","unstructured":"Fujioka S, Suzuki F, Funamizu N, Okamoto T, Munakata K, Ashida H, et al. Stent graft placement and balloon dilation for pseudoaneurysm complicated by distal arterial stenosis of the hepatic artery after pancreaticoduodenectomy. Surg Case Rep. 2015;1:60.","journal-title":"Surg Case Rep."},{"key":"887_CR10","doi-asserted-by":"publisher","first-page":"237","DOI":"10.4174\/astr.2019.96.5.237","volume":"96","author":"Y You","year":"2019","unstructured":"You Y, Choi SH, Choi DW, Heo JS, Han IW, Han S, et al. Long-term clinical outcomes after endovascular management of ruptured pseudoaneurysm in patients undergoing pancreaticoduodenectomy. 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