Experience of surgical management of XXXX in a North Indian Hospital.

@entity1 @entity5572 @entity788 @entity548 @entity1066 @entity439 @entity2270 @entity360 @entity1756
BACKGROUND: Bleeding splanchnic artery @entity439 is a rare but frequently fatal complication that can be successfully managed by angiographic embolization. However, certain @entity1 because of hemodynamic instability, non-availability of technique or angiographic failure may require primary surgical intervention. METHOD: Retrospective review of 13 @entity1 presenting with exsanguinating @entity548 from @entity1756 arising from branches of @entity2270 , managed surgically in absence of angiographic embolization. RESULTS: Splenic artery was most commonly involved (n = 7) followed by hepatic (n = 3), gastroduodenal (n = 2) and left gastric artery (n = 1). The most common underlying aetiology was @entity788 (n = 8, acute = 2; chronic = 6) followed by iatrogenic (n = 3), @entity5572 (n = 1) and gastric @entity1066 (n = 1). Seven @entity1 presented with @entity360 , while 2 each with lower @entity360 , haemobilia and @entity548 through tube drains. CT-scan accurately demonstrated the @entity439 in 11 (84.6%) @entity1 and additionally demonstrated the underlying pathology. The surgical management chiefly consisted of ligation of offending vessel and additional procedures directed at primary pathology. Overall, 77% @entity1 had a favourable outcome while 23% died consequent to ongoing @entity548 . CONCLUSION: Pseudo- @entity439 involving the branches of @entity2270 most commonly arises as a result of @entity788 and affects splenic artery. CT-scan accurately demonstrates @entity439 and associated pathology in majority of cases. Primary surgical management in the presence of hemodynamic instability and non-availability of angiographic embolization is a viable alternative.
