Unusual locations of pseudo aneurysms as a sequel of chronic pancreatitis

Inferior phrenic artery pseudoaneurysm complicating drug-induced acute pancreatitis

“…IPA pseudoaneurysm is an extremely rare condition with only three cases reported in the literature 3 4. Our case describes the first IPA pseudoaneurysm complicating a drug-induced (L-asparaginase) acute pancreatitis.…”

“…The bleeding vessel was embolised with coils and haemostasis was successfully achieved. Surgery is an alternative therapeutic option but with higher morbidity and mortality rates 3. The success rate of angiographic embolisation ranges from 79% to 100% and thus becomes the modality of choice in the treatment of pseudoaneurysms 3…”

Rare presentation of a massive intermittent upper gastrointestinal bleed

“…Frequency of rupture in the setting of pancreatitis is 5-10% and with a pseudocyst present, this can rise up to 20%. Mortality of a ruptured PA can be as high as 90-100% and if treated, the mortality risk is reduced to 12-57% [7][8][9][10].…”

“…Other signs may include residual blood clots located near the ampulla, which may be difficult to visualize with no signs of peptic ulcer disease, varices or gastritis [7]. If no clear bleeding source, CT scan of the abdomen is the first line imaging modality of choice to identify pancreatic pathology followed-by angiography, which is considered the gold standard for detecting PAs and first line treatment [5,10].…”

“…Some of these complications can be avoided with the use of a non-coated metallic stent and the stent can be used as bridge to surgery in high risk patients or those with pancreatic disease that is in need of surgical treatment. The advantages to embolization include precise location, assessment of proper collateral flow, and excellent alternative for patients that are poor surgical candidates [7][8][9][10].…”