Endovascular management of splanchnic arteries bleeding in pancreato-biliary disease

Background. Splanchnic artery bleeding is a life-threatening condition, especially in high-risk patients. The purpose of this study is to evaluate the efficacy of endovascular treatment of splanchnic artery bleeding in pancreato-biliary disease, considered as survival at the 3-month follow-up. Patients and methods. From 1992 to 2001 39 patients with upper splanchnic arterial lesion due to acute and chronic pancreatitis after surgery or percutaneous procedures, or as a complication of aneurysms or trauma, were treated using endovascular techniques. The patients underwent CT control immediately after the procedure, after seven days and then at the 3, 6 and 12-month-follow-up. Results. In some patients, more than one angiography was necessary to identify the source of bleeding. Bleeding was stopped in all treated patients. Fatal re-bleeding occurred in 6 patients and, in the first part of the study, 2 patients died of hepatic failure after hepatic artery embolization. Conclusions. Splanchnic artery bleeding is a life-threatening condition. Endovascular treatment can reach a clinical success rate of up to 75% at three months.