Pancreatic cancer with pseudoaneurysm after duckbill‐shaped anti‐reflux metal stent placement: A case report

Abstract

A 74‐year‐old man was diagnosed with unresectable pancreatic cancer with obstructive jaundice. Chemotherapy with gemcitabine and nab‐paclitaxel was initiated after placement of a duckbill‐shaped anti‐reflux metal stent (D‐ARMS). A period of 1 month after D‐ARMS placement, the patient developed hematemesis and entered severe shock following emergency admission for further evaluation. Contrast‐enhanced computed tomography revealed a pseudoaneurysm in the gastroduodenal artery, coincident with the site of D‐ARMS placement, and bleeding from the same site was diagnosed. Angiography was performed, and the pseudoaneurysm was successfully treated by transcatheter arterial embolization using coils. The patient was subsequently discharged from hospital and experienced no further bleeding until his death due to an aggravation of the pancreatic cancer after 2 months. We report a case of pancreatic cancer with pseudoaneurysm after D‐ARMS placement.

Ruptured cystic artery pseudoaneurysm after self‐expandable metal stent placement for malignant biliary obstruction

“…While pseudoaneurysms after SEMS placement are most commonly found in the right hepatic artery near the distal end of the SEMS, the gastroduodenal and posterior superior pancreaticoduodenal arteries can also be affected. 3,9 In this case, a pseudoaneurysm formed in the cystic artery, which was not in direct contact with SEMS. However, the stent may have exerted pressure on extrabiliary structures including the inflamed gallbladder, playing a role in pseudoaneurysm formation and subsequent rupture.…”

“…Therefore, the mechanical properties of SEMS may affect pseudoaneurysm formation. While pseudoaneurysms after SEMS placement are most commonly found in the right hepatic artery near the distal end of the SEMS, the gastroduodenal and posterior superior pancreaticoduodenal arteries can also be affected 3,9 . In this case, a pseudoaneurysm formed in the cystic artery, which was not in direct contact with SEMS.…”