Quantitative imaging in medicine and surgery · 2026
Off-label use of a WRAPSODYTM stent-graft in the portal vein for septic gas embolism following pancreatic abscess fistulization: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Misbahuddin-Leis Mohammed, Ankolvi Muzaffer, Schramm Krisztina, Farooqui Farah, Müller Thomas, Vorontsov Oleg, Graeb Christian, Radeleff Boris
Аннотация
BACKGROUND: Portal venous gas embolism resulting from fistulizing pancreatic abscesses is exceedingly rare and life-threatening. Management is further complicated when associated with portal vein thrombosis, and no dedicated stent-grafts exist for portal venous reconstruction. Exclusion of the fistulous communication is necessary to prevent ongoing septic embolization.
CASE DESCRIPTION: A 58-year-old male with chronic pancreatitis and prior distal pancreatectomy developed septic portal venous gas embolism due to fistulous communication between a postoperative pancreatic abscess and the portal venous confluence. In the setting of progressive gas embolization and increasing thrombus burden, percutaneous transhepatic endovascular reconstruction was performed. A fully covered WRAPSODYTM stent-graft was deployed to seal the fistulous tract, followed by a balloon-expandable Bentley BeGraftTM to extend coverage and exclude residual mural thrombus.
CONCLUSIONS: Portal venous flow was immediately restored with complete exclusion of the fistulous tract. The patient demonstrated rapid clinical improvement without complications. Follow-up computed tomography (CT) confirmed durable stent patency, resolution of portal venous gas, and regression of thrombus. The WRAPSODYTM stent-graft's trilaminar proprietary trilaminar membrane (PTFE) membrane and high flexibility enabled effective exclusion of a septic portal vein fistula in a complex postoperative setting. Based on a focused review of indexed literature, no prior reports describing WRAPSODYTM stent-graft implantation in the portal venous system were identified. Although further experience is required, this case illustrates a novel off-label application for life threatening portal venous pathology, demonstrating technical feasibility and short-term success.
CASE DESCRIPTION: A 58-year-old male with chronic pancreatitis and prior distal pancreatectomy developed septic portal venous gas embolism due to fistulous communication between a postoperative pancreatic abscess and the portal venous confluence. In the setting of progressive gas embolization and increasing thrombus burden, percutaneous transhepatic endovascular reconstruction was performed. A fully covered WRAPSODYTM stent-graft was deployed to seal the fistulous tract, followed by a balloon-expandable Bentley BeGraftTM to extend coverage and exclude residual mural thrombus.
CONCLUSIONS: Portal venous flow was immediately restored with complete exclusion of the fistulous tract. The patient demonstrated rapid clinical improvement without complications. Follow-up computed tomography (CT) confirmed durable stent patency, resolution of portal venous gas, and regression of thrombus. The WRAPSODYTM stent-graft's trilaminar proprietary trilaminar membrane (PTFE) membrane and high flexibility enabled effective exclusion of a septic portal vein fistula in a complex postoperative setting. Based on a focused review of indexed literature, no prior reports describing WRAPSODYTM stent-graft implantation in the portal venous system were identified. Although further experience is required, this case illustrates a novel off-label application for life threatening portal venous pathology, demonstrating technical feasibility and short-term success.