Chronic pancreatitis is dangerous in
development of various complications, one of the most heavy is the false
aneurism (FA) of the pool of truncus coeliacus and arteria mesenterica
superior. Prevalence of this complication makes 2-10%. The main reason for FA
formation at chronic pancreatitis - destruction of a wall of an artery by
enzymes of pancreatic juice with the subsequent arrosion bleeding in a cavity
of pseudocyst, or in a pancreas parenchyma.
Purpose: to define possibilities of ultrasonography
in diagnostics of visceral arteries’s FA.
Materials
and Methods: 37 patients with FA passed ultrasonography inspection and treatment (men
slightly prevailed – 53,7%, middle age – 48±2,27) during 1995-2013. Duration of
chronic pancreatitis varied from 6 months to 15 years. Results of presurgical
inspection were angiographically/morphologically verified. Artery-source of FA:
lienalis (AL)
– 24(64,9%); pancreatoduodenal (PDA) – 5(13,5%); gastroduodenal – 4(10,8%);
left gastric, mesenterica superior, right hepatic artery departing from
mesenterica superior – 1(2,7%) everyone; gastroduodenal artery and mesenterica
superior vein with formation of arteriovenous fistula through FA cavity – 1(2,7%).
Results: FA sizes and form, condition of its
cavity were determined according to ultrasonography. FA sizes – 20-135 mm.
Two types of FA were diagnosed: arisen in a cavity of pseudocyst and created in
a pancreas parenchyma at the expense of an arrosion of vessel wall and
hemorrhage.
FA wasn't revealed in 2(5,4%) cases (AL and PDA
FA) owing to lack of pseudocyst cavity and the small sizes (<10 mm).
FA cavity was painted completely at duplex
scanning in 12(34,3%) cases, partially (thrombotic masses) – in 23(65,7%)
cases. Artery-source of FA weren't verified in 9(25,7%) cases (are defined in
the subsequent according to CT, angiography).
SA FA: single – 21(87,5%), multiple – 3(12,5%) (3
FA – 2, FA+true aneurism – 1); location: in proximal part of SA - 4(16,7%); in distal –
17(70,8%); in distal part of artery and spleen's gate at multiple FA – 3(12,5%).
Conclusion: Ultrasonography allows to diagnose
visceral arteries’s FA in a cavity of pseudocyst in 100%, in gland parenchyma
at the sizes >10,0 mm and to verify a source of FA in 74,3%.
