A pancreatic hemorrhagic pseudocyst with pseudoaneurysm and the role of doppler ultrasonography: a case report

Ruptured Pancreaticoduodenal Artery Pseudoaneurysm in an Unusual Location in a Patient with Chronic Pancreatitis: A Case Report

“…8 Clinically, the possibility of bleeding pancreatic pseudoaneurysm should be considered if there are any of the following conditions: (1) sudden enlargement of a known pancreatic pseudocyst; (2) audible bruit over a pancreatic pseudocyst regardless of symptoms; (3) upper gastrointestinal bleeding in a patient with known pancreatic pseudocyst and absence of other cause seen on endoscopy; or (4) sudden drop in the hemoglobin level in a patient with known pancreatic pseudocyst, without other apparent cause. 9 Unfortunately, the clinical presentation of acute abdominal pain in our patient is vague and cannot be distinguished from an episode of acute pancreatitis.…”

“…Doppler ultrasound (US) can establish the diagnosis of pseudoaneurysm by demonstrating a classic "yin-yang sign" and "to-and-fro" spectral waveform. 3,7,9 However, US is operator dependent and has low sensitivity in detection of the pancreatic pseudoaneurysm due to its deep retroperitoneal location. 10 CT angiography has higher sensitivity and specificity in diagnosis of pancreatic pseudoaneurysm.…”