Therapeutic embolization of pancreaticoduodenal artery pseudoaneurysm secondary to pancreatitis

Visceral vessel lesions are known complication of pancreatitis and it may cause gastrointestinal hemorrhage. We report a case of superior pancreatico-duodenal artery pseudoaneurysm caused by pancreatitis that was successfully treated by transcatheter arterial embolization using five coil-emboli. A 32-year-old male patient admitted due to sudden onset of hematemesis and passage of fresh bloody stool. He had previous multiple admissions due to alcoholic pancreatitis complicated with pseudocyst and abscess formation that was treated by percutaneous placement of drainage catheter. CT scan study revealed a well-demarcated homogeneously hypodense mass lesion at the region of pancreatic head that enhanced markedly in the post-contrast study, suggestive of pseudoaneurysm. The celiac angiography confirmed a pseudoaneurysm of the anterior superior pancreaticoduodenal artery. The selective transarterial embolization was carried out by using five coil-spring emboli. The bleeding stopped after the embolization. He was discharged six days later in an improved condition except with abdominal pain. This paper describes a case of pseudoaneurysm secondary to pancreatitis presenting with gastrointestinal bleeding that was successfully treated with transcatheter arterial embolization.