Endoscopic ultrasound treatment of vascular complications in acute pancreatitis

Bleeding due to vascular complications of acute pancreatitis is a rare dangerous condition that is diagnostically and therapeutically challenging, and represents the most life-threatening complication of acute pancreatitis. The overall goal of this report is to present a new potential indication for endoscopic ultrasound (EUS)-guided fine-needle injection in the management of vascular complications of pancreatitis, based on continuous real-time visualization of vessels, color flow, and Doppler. EUS has enabled successful sclerotherapy and embolization of the perforating vein of esophagogastric varices and pancreatic pseudoaneurysm, respectively, in a 55-year-old patient with a history of recurrent/chronic alcoholic pancreatitis. This effective procedure represents a minimally invasive therapeutic option and provides an alternative to arterial embolization and surgery in the assessment and management of this category of complications.