Transcatheter management of pseudoaneurysms complicating pancreatitis

Hemorrhage from rupture of an arterial pseudoaneurysm is a potentially fatal complication of pancreatitis. Seventeen patients underwent transcatheter embolization of 23 arteries for the treatment of 20 arterial pseudoaneurysms secondary to pancreatitis. Their records were reviewed retrospectively to evaluate the clinical benefit of transcatheter therapy. At presentation, 15 of the 17 patients had gastrointestinal, intrasplenic, retroperitoneal, intraperitoneal, or postoperative wound bleeding. Transcatheter embolotherapy was the sole treatment for 16 (80%) of the 20 pseudoaneurysms in 13 patients. Four pseudoaneurysms (20%) in four patients were treated prior to splenectomy. Transcatheter therapy was clinically beneficial in all patients. Three patients had procedural complications without significant clinical sequelae. Transcatheter embolotherapy should be the initial treatment of choice in patients with arterial pseudoaneurysms secondary to pancreatitis. Treatment may be definitive or facilitate subsequent surgery.