Pseudoaneurysm associated with complicated pancreatic pseudocysts

Abstract

A pseudoaneurysm associated with a pseudocyst is a serious and unusual complication of chronic pancreatitis. Its treatment is complex due to its elevated mortality and the need for multidisciplinary management. Initial measures consist of locating the hemorrhage through computerized dynamic tomography and arteriography. The treatment of choice is controversial due to the lack of controlled studies. For managing hemorrhages in stable patients, the most accepted initial measure is currently arterial embolization. In the event of failure of the same, hemodynamic instability or the impossibility of drainage of the pseudocyst, surgery is the subsequent therapeutic option.

Mediastinal Pseudocyst: Varied Presentations and Management—Experience from a Tertiary Referral Care Centre in India

“…It could range from bleeding from visceral artery pseudoaneurysm to thrombosis of peripancreatic veins as encountered in our series [18, 19]. We are probably the first to report brachiocephalic vein thrombosis, due to mediastinal pseudocyst.…”

Left Gastric Artery Pseudoaneurysm Complicating Chronic Calcifying Pancreatitis in a Child

“…Pseudoaneurysms can arise in the section of the artery lying either outside the gastric wall (extramural) or inside the gastric wall (intramural). Rupture of pseudoaneurysm can lead to life-threatening hemorrhage into the stomach, peritoneal cavity, or pseudocyst [ 9 ].…”

Hemosuccus Pancreaticus and Obstructive Jaundice: Two Rare Complications of Chronic Pancreatitis Treated by Arterial Embolization

“…The role of surgery in the management of pancreatitis-associated pseudoaneurysms remains controversial. Various authors propose performing arterial embolization as bridging therapy followed by surgical resection to prevent rebleeding, arguing that chronic pancreatitis is an ongoing inflammatory process [11,12], while others suggest surgery only if arterial embolization fails or rebleeding occurs [13] or in hemodynamically unstable patients [14,15].…”