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Fig. 12 | Insights into Imaging

Fig. 12

From: Elucidating early CT after pancreatico-duodenectomy: a primer for radiologists

Fig. 12

Venous extraluminal haemorrhage in a 74-year-old man following pylorus-preserving PD for pT3N1 CBD adenocarcinoma, suffering from hypotension, abdominal pain and blood from drainage tube on postoperative day 7. Urgent CT showed haemoperitoneum, fresh blood (*) extending from the surgical bed in the subhepatic space and mesentery, normal appearance of RP (arrowheads in b). CT-angiography MIP reconstructions (c) did not detect active arterial bleeding or pseudoaneurysms, particularly at the gastroduodenal artery “stump” (thin black arrow). In the venous phase (d) serpiginous CM extravasation (thin arrows) was detected. Emergency surgery was required to control oozing venous bleeding at the transverse mesocolon. (Partially adapted from Tonolini [38])

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