Endoscopic closure of a post-traumatic pancreatic fistula with interventional radiology techniques

AbstractPostoperative pancreatic fistulas are complex, challenging problems that often take weeks, months, or longer to resolve. Multiple interventions may be required to achieve a successful outcome. As such, resolution typically involves a multidisciplinary approach by a team whose skills include abdominal imaging, specialized surgery, advanced endoscopy, and interventional radiology. Intensive resources and time are often required, which impacts both patients and their caregivers. While treatment(s) continue to improve, a primary goal of research efforts in this area is the prevention of this significant source of postoperative morbidity, mortality, and economic strain.

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Intradural Endoscopic Closure of Dural Breaches in a Case of Post-Traumatic Tension Pneumocephalus

min - Minimally Invasive Neurosurgery ◽

10.1055/s-2007-985147 ◽

2007 ◽

Vol 50 (3) ◽

pp. 178-181 ◽

Cited By ~ 4

Author(s):

F. Dewaele ◽

J. Caemaert ◽

E. Baert ◽

J.-P. Kalala ◽

D. Roost

Keyword(s):

Tension Pneumocephalus ◽

Endoscopic Closure ◽

Post Traumatic

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Post-traumatic external pancreatic fistula

The American Journal of Surgery ◽

10.1016/0002-9610(67)90353-4 ◽

1967 ◽

Vol 113 (6) ◽

pp. 816-818 ◽

Cited By ~ 1

Author(s):

Chiu Hsiung Huang ◽

Takeshi Kuyama ◽

Jun Takeda

Keyword(s):

Pancreatic Fistula ◽

Post Traumatic

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Endovascular Interventional Radiology of the Urogenital Tract

Medicina ◽

10.3390/medicina57030278 ◽

2021 ◽

Vol 57 (3) ◽

pp. 278

Author(s):

Fabio Pozzi Mucelli ◽

Roberta A. Pozzi Mucelli ◽

Cristina Marrocchio ◽

Saverio Tollot ◽

Maria A. Cova

Keyword(s):

Interventional Radiology ◽

Endovascular Procedures ◽

Hemorrhagic Cystitis ◽

Arterial Embolization ◽

Urogenital System ◽

Emergency Intervention ◽

Arteriovenous Fistulas ◽

Inflammatory Conditions ◽

Radiation Induced ◽

Post Traumatic

Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.

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Cavitojejunostomy for post-traumatic disconnected pancreatic duct syndrome presenting as persistent external pancreatic fistula: A case report

Indian Journal of Case Reports ◽

10.32677/ijcr.v7i11.3131 ◽

2021 ◽

pp. 497-499

Author(s):

Kelu Sreedharan Sreesanth ◽

Valiya Kambrath Prathapan ◽

Mathew Joseph ◽

Chandran Nirmala Vyshakh

Keyword(s):

Pancreatic Fistula ◽

Pancreatic Duct ◽

Multidisciplinary Approach ◽

Resonance Imaging ◽

Initial Management ◽

Distal Pancreas ◽

Post Traumatic ◽

Operative Recovery ◽

Duct Syndrome

Post-traumatic disconnected pancreatic duct syndrome (DPDS) can present as persistent external pancreatic fistula following percutaneous drainage (PCD) of pancreatic collection. Management of these cases can be difficult and involves a multidisciplinary approach. Here, we present a case of a 16-year-old boy who presented with persisted pancreatic fistula following initial management including PCD of peripancreatic collection following polytrauma 3 months prior. Magnetic resonance imaging showed a disconnected pancreatic duct. Intraoperatively, there was a disconnected and viable distal pancreas with a defect cavity measuring 2 × 2 cm at the neck of the pancreas. The wall of the cavity was anastomosed with a Roux limb of the jejunum (cavitojejunostomy). Post-operative recovery was uneventful and the patient remains asymptomatic at 2 months of follow-up. Cavitojejunostomy is a feasible and safe surgical option in DPDS with a well-formed cavity. This avoids dissection in difficult anatomical planes and preserves pancreatic parenchyma.

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