Clinical Endoscopy

Role of fully covered metal stents in the management of chronic pancreatitis: Younghun Jeon, Hoonsub So, Sung Jo Bang; Received December 26, 2024 Accepted February 13, 2025 Published online May 8, 2025; DOI: https://doi.org/10.5946/ce.2024.349 [Epub ahead of print]

Abstract PDF PubReader ePub: Chronic pancreatitis (CP), a progressive inflammatory disease that results in irreversible pancreatic damage, is often complicated by ductal strictures and debilitating pain. Fully covered self-expandable metal stents (FCSEMS) have emerged as significant innovations in the endoscopic management of refractory pancreatic duct strictures. This review synthesizes recent evidence highlighting the benefits and limitations of FCSEMS, such as superior patency, reduced need for reinterventions, and effective symptom relief compared to traditional plastic stents, alongside risks, such as stent migration and de novo strictures. A comparison with plastic stents and an algorithm for pancreatic duct stricture management are provided. Regional variations in clinical guidelines from the United States, Europe, Japan, and Korea reflect diverse approaches to integrating FCSEMS into practice. Emerging innovations in stent technology are promising for improving CP management outcomes.

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Refractory benign biliary stricture due to chronic pancreatitis in two patients treated using endoscopic ultrasound-guided choledochoduodenostomy fistula creation: case reports: Sho Ishikawa, Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Yasuhiro Kuraishi, Takafumi Yanaidani; Clin Endosc 2024;57(1):122-127. Published online May 16, 2023; DOI: https://doi.org/10.5946/ce.2022.149

Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) fistula creation. A 50-year-old woman and a 60-year-old man both presented with obstructive jaundice secondary to BBS due to alcoholic CP. They underwent repeated placement of a fully covered self-expandable metal stent for biliary strictures. However, the strictures persisted, causing repeated episodes of cholangitis. Therefore, an EUS-CDS was performed. The stents were eventually removed and the patients became stent-free. These fistulas have remained patent without cholangitis for more than 2.5 years. Fistula creation using EUS-CDS is an effective treatment option for BBS.

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Forward viewing liner echoendoscopy for therapeutic interventions
Kazuo Hara, Nozomi Okuno, Shin Haba, Takamichi Kuwahara
Clinical Endoscopy.2024; 57(2): 175. CrossRef
Successful sequential management of traumatic choledochal leak and stenosis in children using ERCP: a case report and literature review
Cuo Leng, Yu Zou, Zhoujian Yang, Xinhua Zhao
Frontiers in Medicine.2024;[Epub] CrossRef

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An Impacted Pancreatic Stone in the Papilla Induced Acute Obstructive Cholangitis in a Patient with Chronic Pancreatitis: Kwang-Ho Yoo, Chang-Il Kwon, Sang-Wook Yoon, Won Hee Kim, Jung Min Lee, Kwang Hyun Ko, Sung Pyo Hong, Pil Won Park; Clin Endosc 2012;45(1):99-102. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.99

Abstract PDF PubReader ePub

Obstructive jaundice is very rarely caused by impaction of a pancreatic stone in the papilla. We report here on a case of obstructive jaundice with acute cholangitis that was caused by an impacted pancreatic stone in the papilla in a patient with chronic pancreatitis. A 48-year-old man presented with acute obstructive cholangitis. Abdominal computed tomography with the reconstructed image revealed distal biliary obstruction that was caused by a pancreatic stone in the pancreatic head, and there was also pancreatic ductal dilatation and parenchymal atrophy of the pancreatic body and tail with multiple calcifications. Emergency duodenoscopy revealed an impacted pancreatic stone in the papilla. Precut papillotomy using a needle knife was performed, followed by removal of the pancreatic stone using grasping forceps. After additional sphincterotomy, a large amount of dark-greenish bile juice gushed out. The patient rapidly improved and he has remained well.

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Citations to this article as recorded by

Pancreatic stones causing secondary biliary obstruction: An uncommon presentation of chronic pancreatitis
Wesley C. Judy, Tom K. Lin
JPGN Reports.2024; 5(3): 414. CrossRef
The “squeezing with forceps” method for emergency endoscopic removal of an impacted pancreatic stone in the papilla of a patient on antithrombotic therapy
Sho Kitagawa, Shori Ishikawa, Keiya Okamura
Endoscopy.2023; 55(S 01): E454. CrossRef
Biliary Outlet Obstruction Due to Pancreatic Calculi in a Post-cholecystectomy Patient
Joey Almaguer, Dylan Murray, Matthew Murray, Richard Murray
Cureus.2023;[Epub] CrossRef
Ampullary Stone in Chronic Pancreatitis Causing Obstructive Jaundice and Cholangitis
Sandheep Janardhanan, Allwin James, Alagammai Palaniappan, Ramesh Ardhanari
Gastroenterology, Hepatology and Endoscopy Practice.2021; 1(2): 69. CrossRef
Ursodeoxycholic acid attenuates 5‑fluorouracil‑induced mucositis in a rat model
Seung Kim, Hoon Chun, Hyuk Choi, Eun Kim, Bora Keum, Yeon Seo, Yoon Jeen, Hong Lee, Soon Um, Chang Kim
Oncology Letters.2018;[Epub] CrossRef
Pancreatic Calculus Causing Biliary Obstruction: Endoscopic Therapy for a Rare Initial Presentation of Chronic Pancreatitis
Anurag J. Shetty, C. Ganesh Pai, Shiran Shetty, Girisha Balaraju
Digestive Diseases and Sciences.2015; 60(9): 2840. CrossRef

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Gastric Involvement in Autoimmune Pancreatitis: Seung Don Baek, M.D., Myung Hwan Kim, M.D., Yun Ku Kim, M.D., Do Hoon Kim, M.D., Jihun Kim, M.D.*, Sang Soo Lee, M.D., Dong Wan Seo, M.D. and Sung Koo Lee, M.D.; Korean J Gastrointest Endosc 2011;42(3):201-204. Published online March 28, 2011

Abstract PDF: Autoimmune pancreatitis is now considered to be a systemic fibroinflammatory disease that can involve multiple organs. As it is associated with IgG4-positive plasma cells by an autoimmune mechanism, extrapancreatic organs as well as the pancreas could be affected with a lymphoplasmacytic infiltrate. The proximal bile duct, the salivary gland, the retroperitoneum and the kidney are well known to be involved with, but less is known about the involvement of hollow viscus which is pathologically associated with autoimmune pancreatitis. We report here on a case of gastric involvement in a 53-year-old man with autoimmune pancreatitis. (Korean J Gastrointest Endosc 2011;42:201-205)

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Endoscopic Treatment of Chronic Pancreatitis: Hong Sik Lee, M.D., Ph.D.; Korean J Gastrointest Endosc 2010;40(5):291-296. Published online May 30, 2010

Abstract PDF: Endoscopic treatments are being increasingly used for chronic pancreatitis. Themost common indications for endoscopic treatment are pancreatic duct stones (requiring removal) and pancreatic duct stricture (requiring stenting). Endoscopic treatment is also widely indicated for drainage of pseudocyst and ceiliac plexus block/neurolysis. In this review, I discuss techniques, efficacy and complications of various endoscopic treatments for chronic pancreatitis. (Korean J Gastrointest Endosc 2010;40:291-296)

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A Case of Hemosuccus Pancreaticus Mistaken for Hemobilia: Seung Hwa Lee, M.D., Dong Hee Koh, M.D., Seon Wook Park, M.D., Ji Youn Kim, M.D., Young Wook Kim, M.D., Hyun Joo Jang, M.D., Sea Hyub Kae, M.D. and Jin Lee, M.D.; Korean J Gastrointest Endosc 2009;39(6):389-392. Published online December 30, 2009

Abstract PDF: Hemosuccus pancreaticus is a rare cause of chronic and intermittent chronic gastrointestinal hemorrhage, and this condition cannot be easily detected by endoscopy. We report here on a 51-year-old woman with obstructive jaundice and a history of acute pancreatitis and chronic alcoholism. Abdominal computed tomography showed a dilated distal common bile duct. We performed endoscopic retrograde cholangiopancreatography to decompress the bile duct and we found a blood clot on the orifice of the ampulla of Vater. Hemobilia with massive bleeding was seen during the examination. Angiography for controlling the hemorrhage showed the pseudoaneurysm of the pancreaticoduodenal artery. Angiographic embolization was successful for controlling the arterial hemorrhage. The patient remained symptom-free and he was discharged without complications. (Korean J Gastrointest Endosc 2009;39:389-392)

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A Case of Focal Autoimmune Chronic Pancreatitis Improved with Oral Steroid Therapy: Sang Hyun Park, M.D., Jung Ho Kim, M.D., Soon Joo Kim, M.D., Jin Kyung Ryu, M.D., Sang Hyo Shin, M.D., Hyun Deok Shin, M.D., Chang Lae Jo, M.D., Tae Yoon Lee, M.D., Sang Soo Lee, M.D., Dong Wan Seo, M.D., Sung Koo Lee, M.D. and Myung-Hwan Kim, M.D.; Korean J Gastrointest Endosc 2007;34(3):179-183. Published online March 30, 2007

Abstract PDF: Clinically, patients with pancreatic cancer and focal autoimmune chronic pancreatitis share many features, such as being elderly, painless jaundice, new-onset diabetes mellitus, and weight loss. Hence, it is difficult to differentiate between the two conditions. Nevertheless, it is very important to distinguish between focal autoimmune chronic pancreatitis and pancreatic cancer because they have different treatment modalities and prognoses. We encountered a case of a 72-year-old man who developed painless jaundice. The patient was diagnosed with focal autoimmune chronic pancreatitis instead of pancreatic cancer from the CT, ERCP, MRCP findings accompanying with an increased IgG4 level. The abnormalities in the clinical, laboratory, and radiological findings improved after 2 weeks of oral steroid treatment. After 3 months of oral steroid treatment, his disease showed further improvement. To our knowledge, this is a rare case of focal autoimmune chronic pancreatitis that improved with oral steroid treatment. (Korean J Gastrointest Endosc 2007;34:179⁣183)

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Dilatation of Narrowed Pancreatic Duct Using a Soehendra Stent Retriever in Chronic Pancreatitis Patients: Seoung Joon Hwang, M.D., Myung Kwan Ji, M.D.*, Jae Woo Kim, M.D.*, Hyun Soo Kim, M.D.*, Kuen Man Lee, M.D., Young Gyun Kim, M.D., Dae Hoon Song, M.D., Yong Han Paik, M.D., Se Joon Lee, M.D. and Dong Ki Lee, M.D.; Korean J Gastrointest Endosc 2006;32(1):27-32. Published online January 30, 2006

Abstract PDF: Background
/Aims: Endoscopic pancreatic ductal drainage may help alleviate the pain from chronic pancreatitis, but stricture dilatation may be technically difficult. Dilatation of high grade strictures of the pancreatic ducts with using dilating or balloon catheters may result in failure. We evaluated the efficacy of using the Soehendra stent retriever as a dilator. Methods: Fourteen patients with pancreatic stricture had dilation performed with a Soehendra stent retriever. Each patient had sphincterotomy, guidewire placement and stent retriever dilatation. Results: All procedures were successful and none of the patients had complications. Symptom relief was observed after dilation in all patients. There was no complication associated with the use of the stent retriever. None of the patients have relapsed for 6 months. Conclusions: The Soehendra stent retriever is safe and effective as a dilating device for the pancreatic strictures that are resistant to conventional dilation. (Korean J Gastrointest Endosc 2006;32:27⁣32)

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The Clinical Usefulness of Fecal Elastase-1 Test as an Exocrine Pancreatic Function Test for the Diagnosis of Chronic Pancreatitis: Sung Hee Lee, M.D. and Ho Soon Choi, M.D.; Korean J Gastrointest Endosc 2004;29(6):500-513. Published online December 30, 2004

Abstract PDF: Background
/Aims: The quantitative analysis of fecal elastase-1 has been proposed as a noninvasive test for the examination of pancreatic exocrine function. Therefore, we evaluated the diagnostic value of fecal elastase-1 by comparing with endoscopic intraductal secretin test (IDST) which is used as a direct exocrine function test for the diagnosis of chronic pancreatitis. Methods: Fecal elastase-1 concentrations were measured by ELISA in spot stool samples of 40 healthy control subjects, 21 patients with liver disease, and 12 patients with chronic pancreatitis diagnosed with endoscopic retrograde cholangiopancreatography (ERCP) and IDST. Chronic pancreatitis were then sub- classified into mild (I), moderate (II) and severe form (III), using the Cambridge classification according to ERCP finding. The linear regression analysis to evaluate the correlation between the concentration of fecal elastase-1 and IDST was performed during ERCP. The cut-off value of fecal elastase-1 to discriminate chronic pancreatitis was calculated based on receiver operating characteristic curve, and the clinical usefulness of fecal elastase-1 in the diagnosis of chronic pancreatitis was evaluated. Results: There were several significant correlations between fecal elastase-1 and various parameters of IDST: pancreatic juice secretory volume (r=0.797, p＜0.002), bicarbonate concentration (r=0.846, p＜0.001), elastase-1 concentration in pancreatic juice (r=0.671, p＜0.017), and amylase output (r=0.783, p＜0.003). The mean value of fecal elastase-1 concentration in the patients with chronic pancreatitis (197±77μg/g stool) was significantly lower than those in the healthy control subjects (815±133μg/g stool) and patients with liver disease (594±206μg/g stool) (p＜0.05). The cutoff value of fecal elastase-1 to discriminate between the healthy control and chronic pancreatitis patients was 201μg/g stool. With this cutoff value, the accuracy, sensitivity, and specificity of fecal elastase-1 to diagnose chronic pancreatitis were 78.8%, 67.7%, and 82.5%, respectively, compared to the morphological severity (the sensitivity of mild, moderate, and severe chronic pancreatitis was 33.3%, 66.7%, 83.3%, respectively). Conclusions: Measurement of fecal elastase-1 is a reliable and sensitive non-invasive test for the diagnosis of moderate to severe forms of chronic pancreatitis. (Korean J Gastrointest Endosc 2004;29:500⁣508)

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A Case of Hemosuccus Pancreaticus Showing Active Bleeding from the Ampulla of Vater: Hyun Bae Son, M.D., Young-Soo Moon, M.D., Jeon Ho Yang, M.D., Cho-Rhom Ham, M.D., Seuk Hyun Lee, M.D., Ung Ryu, M.D., Jea Wook Roh, M.D., Sang Eun Lee, M.D., Kyung-Ah Kim, M.D. and Yun Hee Han, M.D.*; Korean J Gastrointest Endosc 2004;28(5):267-272. Published online May 30, 2004

Abstract PDF: Hemorrhage through the pancreatic duct into the duodenum, so called 'hemosuccus pancreaticus', is a rare cause of gastrointestinal bleeding with diagnostic difficulties. We report a 44-year-old man with recurrent upper gastrointestinal bleeding due to rupture of pseudoaneurysm into the pancreatic duct. Initial upper gastrointestinal endoscopy failed to identity the site of the hemorrhage. Active bleeding from the ampulla of Vater in duodenum was found on repeat endoscopy. Abdominal computed tomography disclosed pseudoaneurysm arising from the splenic artery caused by chronic pancreatitis. Splenic angiogram showed large psudoaneurysmal sac with wide neck, arising from distal splenic artery. Angiographic embolization was successful in controlling the arterial hemorrhage. The patient remained symptom-free 5 months after the embolization. Hemosuccus pancreaticus, although rare, remains important in the differential diagnosis of upper gastrointestinal bleeding of obscure orgin. (Korean J Gastrointest Endosc 2004;28:267⁣272)

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가성 낭종을 합병한 만성 췌장염 환자에서의 위정맥류 1예: Korean J Gastrointest Endosc 2003;27(5):451-451. Published online November 20, 2003

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만성췌장염에서 발생한 진단이 어려웠던 가성동맥류 2 예 - 천자와 hemosuccus pancreaticus 로 확인된 가성동맥류 - ( Two Difficultly Diagnosed Cases with Pseudoaneurysm in Chronic Pancreatitis - Pseudoaneurysms Identified Inadvertently during Percutaneous Drainage and Hemosuccus Pancreaticus - ): Korean J Gastrointest Endosc 2001;23(4):263-268. Published online November 30, 2000

Abstract PDF: Pseudoaneurysm is a rare life-threatening complication of chronic pancreatitis. It can be diagnosed by various imaging modalities including computerized tomography (CT), ultrasound, and angiography. Early diagnosis and radiologic or surgical treatment can promise better outcomes. However, pseudoaneurysm is not easily diagnosed. It can be misdiagnosed as a pseudocyst with secondary infection. Rarely, the correct diagnosis is made by an inadvertent trial with percutaneous drainage. The endoscopically identified hemosuccus pancreaticus is also a rare finding. Recently, we experienced two cases of pseudoaneurysm in patients with chronic pancreatitis. They did not have any evidence of bleeding in the initial eddoscopy or evidence of pseudoaneurysms in the initial ultrasound and CT scan. In one case, the pseudoaneurysm was identified during a percutaneous drainage procedure, performed to diagnose and manage a cystic lesion which apperared to be an infected cyst. In the other case, the pseudoaneurysm was suspected after the hemosuccus pancreaticus was found during endoscopy performed due to recurrent hematemesis. Both cases were successfully treated with arterial embolization of the pseudoaneurysms. (Korean J Gastrointest Endosc 2001;23:263-268)

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췌장 외분비 기능검사로서 내시경적 췌관 내 세프레틴 검사 ( Intraductal Secretin Test )의 유용성 ( Usefulness of Intraductal Secretin Test in Assessing Exocrine Pancreatic Function in Patients with Chronic Pancreatitis ): Korean J Gastrointest Endosc 2000;21(3):723-729. Published online November 30, 1999

Abstract PDF: Background
/Aims: The duodenal intubation test (duodenal secretin test; DST) is now considered the 'gold standard' test of exocrine pancreatic function in detecting exocrine pancreatic dysfunction in patients witd chronic pancreatitis. However, the DST has not been widely used, because it is time-consuming, invasive, and labor-intensive. On the other hand, intraductal secretin test (IDST) with endoscopic retrograde cannulation cf the main pancreatic duct has been showed similar diagnostic efficiency compared with DST. We assessed the clinical usefulness of IDST and investigated parameters for assessing impaired pancreatic function of IDST. Methods: Pure pancreatic juices were collected from 12 patients with chronic pancreatitis by endoscopic cannulation after a bolus intravenous injection of secretin 100 U, for 15min in three 5-min intervals. Five parameters of IDST were measured, and the sensitivity, specificity, and accuracy of IDST evaluated compared with ERP. Results: When we regarded mean-l.5 SD as the lower limits of IDST, the diagnostic sensitivity, specificity, and accuracy of five parameters to detect chronic pancreatitis were 91.7-100%, 75-87.5%, and 85-90%, respectively. Among five parameters, pancreatic juice secretory volume, bicarbonate concentration, and amylase output showed the highest diagnostic accuracy, followed by lipase output and bicarbonate output. A 10-min collection showed as much information as a 15-min collection. Conclusions: 10-min intraductal secretin test is useful as the conventional exocrine pancreatic function test in detecting exocrine pancreatic dysfunction in patients with chronic pancreatitis and the most discriminatory parameters are pancreatic juice secretory volume, bicarbonate concentration, and amylase output.

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Haemosuccus Pancreaticus 1예 ( A Case of Haemosuccus Pancreaticus ): Korean J Gastrointest Endosc 2000;20(3):222-226. Published online November 30, 1999

Abstract PDF: Haemosuccus pancreaticus describes the syndrome of gastrointestinal bleeding into the pancreatic duct, manifested by blood loss through the ampulla of Vater. It has been confined mainly to small series or isolated case reports in patients with chronic pancreatitis with pseudocysts. Endoscopy is useful mostly to exclude other sources of hemorrhage but visualization of bleeding from the papilla is a rare event. A case in herein reported of a patient, suffering from bleeding into the pancreatic duct, who had a history of recurrent, chronic pancreatitis with pseudocysts for 6 months. During duodenoscopic examination, bleeding from the papilla of Vater was identified, however the alternative cause was not suggestive. In alcoholic pancreatitis, recurrent eipsodes of acute pancreatitis with pancreatic ductal hemorrhage is a natural history, so resection of the affected segment of the pancreas can be the treatment of choice. A distal pancreatectomy and splenectomy was performed.

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만성 췌장염에 합병된 하대정맥 및 슬와정맥 혈전증 1예 ( A Case of Thrombosis of the Inferior Vena Cava and Right Iliac Vein Complicated by Chronic Pancreatitis ): Korean J Gastrointest Endosc 2000;20(2):158-162. Published online November 30, 1999

Abstract PDF: Vascular thrombosis and systemic hypercoagulable states are known complications of pancreatitits. The incidence of vascular obstruction associated with pancreatitis has been reported at 0.9%. They are thought to be secondary to release of proteolytic enzymes of the pancreas and direct vasculitis. Vessels near the head of the pancreas are more frequently involved, and arterial vessels are most commonly affected. Inferior vena cava (IVC) thrombosis however, is a very rare presentation of acute and chronic pancreatitis. Dignosis of IVC thrombosis may be far from easy; the presence of a leg edema, superficial thrombophlebitis or thromboembolic events may arouse clinical suspicion. Therefore, a high degree of suspicion for this complication is necessary in order to render a diagnosis. A case of a 24-year old man with chronic pancreatitis, who was found to have IVC and right iliac vein thrombosis, is herein report with a review of the relevant literature.

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부유두 내 췌관 배액관 삽입술 및 부유두 괄약근 절개술로 호전된 만성 췌장염 1 예 ( One Case of Endoscopic Stenting with Minor Papilla Sphincterotomy in a Patient with Chronic Pancreatitis ): Korean J Gastrointest Endosc 1999;19(3):491-496. Published online November 30, 1998

Abstract PDF: The anatomy of the pancreatic ducts and their variations are best defined through a pancreatography, which is especially useful for determining the appropriate endoscopic management. Pressure in the pancreatic ductal system has been shown to be significantly higher in patients with painful chronic pancreatitis and dilated ducts when compared with pressure in controls. The aim of pancreatic drainage procedures is to improve the outflow of pancreatic juice, thereby lowering intraductal pressure and affording relief of pain. It is necessory for both endoscopic pancreatic sphincterotomy (EPS) and stenting have to be performed at the papilla of the dominant duct, which is the Wirsung duct (embryologic "ventral" duct), in the majority such of cases. An EPS of the minor papilla should be considered when the duct of Santorini (embryologic "dorsal" duct) predominates, as in patients with complete or incomplete divided ducts or with a distorted connection between the ventral and the dorsal duct. In these patients, access to the main pancreatic duct (MPD) is easier through the duct of Santorini. A 42 year-old man was admitted with chronic recurrent pancreatitis. Minor papilla sphincterotomy and endoscopic stent placement were performed for the drainage of the dorsal pancreatic duct. After stenting of the minor papilla, abdominal pain disappeared and pancreatitis did not develop after a 7 month follow-up, the stent was changed. (Korean J Gastrointest Endosc 19: 491∼496, 1999)

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증례 : 식도 위장관 ; 대장암 양상을 보인 만성췌장염에 의한 대장폐색 ( Case Reports : Esophagus , Stomach & Intestine ; Stenosis of the Colon Due to Chronic Pancreatitis Mimicking Colon Cancer ): Korean J Gastrointest Endosc 1998;18(4):605-610. Published online November 30, 1997

Abstract PDF: Obstruction of the gastrointestinal tract by the progressive fibrotie process of chronic pancreatitis is being recognized with increasing frequency. The structures commonly affected are parapancreatic in location and include the common bile duct in its intrapancreatic portion, the second and third portion of the duodenum and the colon, most commonly the transverse segment. Colonic involvement of varying severity is less common and not well recongnized, and stenosing lesions of the colon are a rare and confusing sequale to pancreatitis. Some cases of colonic stenosis complicated by pancreatitis cannot be differentiated radiologically from carcinoma. The clinical history, enzyme studies and location of the stenosis in the left colon may alert the clinician to this rare diagnosis. We report a patient with stenosis of the colon due to chronic pancreatitis in whom the initial presenting symptoms and radiologic finding resemble colon cancer. (Korean J Gastrointest Endosc 18: 6ll5-610, 1998)

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증례 : 담도 췌장 ; 만성췌장염에 동반된 가성동맥류 1예 ( Case Reports : Biliary Tract & Pancreas ; A Case of a Pseudoaneurysm in Chronic Pancreatitis ): Korean J Gastrointest Endosc 1998;18(2):276-280. Published online November 30, 1997

Abstract PDF: The bleeding pseudoaneurysm is a rare condition but one of the lethal complications in patients with chronic pancreatitis. Early diagnosis and emergent intervention can reduce mortality and promise better outcomes. We experienced a case of a bleeding pseudo- aneurysm in a chronic pancreatitis patient. The 44-year-old male was suffering from con- tinuous, vague epigastric pain and black tarry stool. An abdominal CT scan revealed a homogeneously enhancing round mass in the pancreatic pseudocyst, and celiac angi- ography found that a pseudoaneurysm had originated from the pancreaticoduodenal artery. The patient was treated with Whipple's operation and was later discharged, having improved in his condition. (Korean J Gastrointesl Endosc 18: 276-280, 1998)

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