EUS GUIDED GLUE+LIPIODOL INJECTION IN PSEUDOANEURYSM OF PANCREATODUODENAL ARTERY: WHAT WENT WRONG!

46 year male with haematemesis and malena. CECT abdomen- acute on chronic pancreatitis, 12 by 13 mm pseudoaneurysm in wall of proximal second part of duodenum from superior pancreatico duodenal artery. Pseudoaneurysm came in good injecting position only in left lateral position. 1.5ml cyanoacrylate glue with 3 ml lipiodol injected using 19 G needle. 2.3ml confirmed arrest of blood flow. In supine position the glue extravasated in common hepatic artery (CHA) and right gastroepiploic artery. Post severe lactic acidosis developed. Managed conservatively. After a week developed gall bladder necrosis. Cholecystetomy done. Conclusion- Always do EUS vascular intervention in supine position.

Publication History

Article published online:
14 April 2022