Embolization of a Large Pancreatic Pseudoaneurysm Converted from Pseudocyst (Hemorrhagic Pseudocyst)

Karlo Novacic, Vinko Vidjak, Slaven Suknaic, Andrija Skopljanac

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Abstract

Context Bleeding pancreatic pseudoaneurysms are a rare complication of chronic pancreatitis with a severe prognosis and high mortality. Conversion of a pancreatic pseudocyst into a pseudoaneurysm is a potentially lethal complication because, when rupture occurs, there is a high mortality rate. Case report We describe a case of pancreatic pseudoaneurysm converted from a pseudocyst. A 57-year-old man with chronic pancreatitis and alcoholic liver cirrhosis presented with abdominal pain in the upper epigastric region. CT and a selective angiogram of the superior mesenteric artery showed a large bleeding pancreatic pseudoaneurysm. The pseudoaneurysm was successfully treated with coil embolization of the feeding artery. Conclusion Endovascular trans-catheter embolization for the treatment of pancreatic pseudoaneurysms is a safe, effective and repeatable procedure with high success rates and it should be used as a treatment of choice in appropriate patients, either as a temporizing measure to control active bleeding and allow hemodynamic stabilization for a surgical procedure or as a definitive treatment.

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