Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Dec 20;11(4):114-119.
doi: 10.22551/2024.45.1104.10301. eCollection 2024.

Superior pancreaticoduodenal artery pseudoaneurysm with subsequent hemosuccus pancreaticus: an unusual complication of chronic pancreatitis

Ali Safar  1 , Abdullah AlFawaz  1   2
Affiliations
Case Reports

Superior pancreaticoduodenal artery pseudoaneurysm with subsequent hemosuccus pancreaticus: an unusual complication of chronic pancreatitis

Ali Safar et al. Arch Clin Cases. .

Abstract

The development of an arterial pseudoaneurysm is an unusual complication of chronic pancreatitis. The most commonly involved artery is the splenic artery. This is a case report describing a case of a superior pancreaticoduodenal artery pseudoaneurysm in a patient with chronic pancreatitis who developed hemosuccus pancreaticus. A 46-year-old man with history of binge ethanol intake presented to the emergency department with abdominal pain. A computed tomography (CT) scan showed features of chronic pancreatitis along with a 2 x 1.8 cm enhancing mass at the level of the pancreatic head, consistent with an arterial pseudoaneurysm in close proximity to the pancreatic duct as confirmed on endoscopic ultrasound. He underwent an endoscopic retrograde cholangiopancreatography in the context of a rise in his liver enzymes with the presence of gallbladder sludge. This was complicated by hemosuccus pancreaticus, which was successfully managed with percutaneous angioembolization. Despite its unusual incidence, pseudoaneurysm remains an important complication of chronic pancreatitis with a high mortality rate in case of acute hemorrhage. Diagnostic modalities include abdominal CT and Color Doppler ultrasound. Endovascular techniques are considered to be the first line of therapy in most cases. Early recognition and management of pancreatic pseudoaneurysms is important to avoid life-threatening hemorrhage.

Keywords: angioembolization; chronic pancreatitis; pseudoaneurysm; superior pancreaticoduodenal artery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
CT abdomen: A) Atrophic pancreas with multiple calcifications (blue arrow) B) Arterial pseudoaneurysm measuring 2x1.8 cm (red arrow).
Fig. 2
Fig. 2
Endoscopic ultrasound showing a vascular lesion at the level of the pancreatic head, consistent with an arterial pseudoaneurysm.
Fig. 3
Fig. 3
Angiography: A) Before coil embolization of the pseudoaneurysm (blue arrow) B) After coil embolization (red arrow).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bergert H, Hinterseher I, Kersting S, et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery. 2005 Mar;137(3):323–8. doi: 10.1016/j.surg.2004.10.009. - DOI - PubMed
    1. Hoilat GJ, Mathew G, Ahmad H. StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Pancreatic Pseudoaneurysm. [Updated 2023 Jul 17] [Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK430937/, at 3/12/2024] - PubMed
    1. Carmeci C, McClenathan J. Visceral artery aneurysms as seen in a community hospital. Am J Surg. 2000 Jun;179(6):486–9. doi: 10.1016/S0002-9610(00)00380-9. - DOI - PubMed
    1. Shanley CJ, Shah NL, Messina LM. Common splanchnic artery aneurysms: splenic, hepatic, and celiac. Ann Vasc Surg. 1996 May;10(3):315–22. doi: 10.1007/BF02001900. - DOI - PubMed
    1. Waslen T, Wallace K, Burbridge B, et al. Pseudoaneurysm secondary to pancreatitis presenting as GI bleeding. Abdom Imaging. 1998 May-Jun;23(3):318–21. doi: 10.1007/s002619900349. - DOI - PubMed

Publication types

LinkOut - more resources