Overview
Peripancreatic hematoma refers to bleeding around the pancreas, often associated with pancreatic artery aneurysms or trauma, posing risks of complications such as rupture and pancreatitis 1.Diagnosis
Clinical Presentation: May include abdominal pain, hypotension, and signs of shock 1.
Imaging: CT angiography is crucial for identifying aneurysms and hematoma extent 1.
Concomitant Conditions: Often associated with celiac axis pathology and other visceral aneurysms 1.Management
Endovascular Treatment: Preferred for many cases, including embolization techniques 1.
Surgical Intervention: Considered for complex or failed endovascular approaches 1.
Combined Methods: Used in select cases where both endovascular and surgical strategies are necessary 1.
Monitoring: Close follow-up required to monitor for complications like pancreatitis or embolization-related issues 1.Special Populations
Comorbidities: Associated with celiac axis pathology, requiring comprehensive evaluation 1.
No Specific Guidance: Limited data on pediatrics, pregnancy, or elderly-specific management 1234.Key Recommendations
Prompt intervention is recommended for peripancreatic aneurysms regardless of size due to rupture risk (Evidence: Strong 1).
Endovascular methods should be considered first-line for managing peripancreatic hematomas 1.
Patients should undergo thorough imaging to assess for concomitant aneurysms and celiac axis involvement before treatment (Evidence: Moderate 1).
Close post-treatment monitoring is essential to detect early complications such as pancreatitis or embolization-related issues (Evidence: Weak 1).References
1 Kang J, Kim S, Yang SS, Kim YW, Do YS, Park KB et al.. Clinical Characteristics and Management of Peripancreatic Arterial Aneurysms: A 20-year Experience. Angiology 2025. link
2 Shaikh N, Rehman NU, Salazar MF, Grodman RS. Spontaneous intramural atrial hematoma presenting as a left atrial mass. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 1999. link70108-2)
3 Yamamoto M, Shimizu M, Kawabata S, Terai M. Effects of YM-14673, a new TRH analogue, on neurological deficits in rats with experimental cerebral hematoma. Archives internationales de pharmacodynamie et de therapie 1989. link
4 Som PM, Patel S, Nakagawa H, Anderson PJ. Case report. The iron rim sign. Journal of computer assisted tomography 1979. link