Ruptured Pseudoaneurysm Associated with Pancreatic Pseudocyst during the follow-up Period -Report of a Case and Review of the Literature-

Takanori Tabo, Hideki Hayashi, Chika Tsuchida¹⁾ and Hisashi Onodera²⁾

Department of Surgery, Department of Radiology¹⁾, Hayashi General Hospital
Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University²⁾

Pseudoaneurysm rupture is a majior complication in managing patients with pancreatic pseudocysts. We treated a ruptured splenic pseudoaneurysm associated with an alcoholic pseudocyst with transcatheter arterial embolization (TAE) followed by distal pancreatectomy. A 31-year-old man followed up for alcoholic pancreatitis and a subsequent pancreatic pseudocyst over 3 years was found in initial abdominal computed tomography (CT) to have a cystic lesion 5 cm in diameter localized in the pancreatic tail. The CT study was made due to a history of recent abdominal pain. The enhanced tiny lesion was found near the splenic hilus in addition to the previously found pseudocyst, suggesting the development of splenic pseudoaneurysm. CT repeated 3 months later in follow-up showed the ruptured pseudoaneurysm to the pancreatic pseudocyst. TAE using a microcoil was used to avoid rupturing the enlarged pancreatic pseudocyst, a potentially fatal event for the patient. Elective distal pancreatectomy and splenectomy 2 weeks resulted in satisfactory recovery and freedom from disease more than 2 years after surgery.

Key words
pancreatic pseudocyst, pseudoaneurysm, chronic pancreatitis

Reprint requests
Takanori Tabo Department of Surgery, Hayashi General Hospital 1-5-7 Fuchu, Takefu, 915-8511 JAPAN

Accepted
January 22, 2003

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