Embolisation of metachronous pseudoaneurysms complicating chronic pancreatitis

Area of Science:

• Interventional Radiology
• Gastroenterology
• Vascular Surgery

Background:

• Pseudoaneurysm bleeding is a known complication of chronic pancreatitis.
• Metachronous pseudoaneurysms (occurring at different times) are rarely reported in this context.
• Effective management strategies for recurrent pseudoaneurysm bleeding in chronic pancreatitis require further investigation.

Purpose of the Study:

• To present a case of metachronous pseudoaneurysm bleeding in chronic pancreatitis.
• To describe the successful management of these sequential pseudoaneurysms using angiographic embolisation.
• To evaluate the efficacy and repeatability of embolisation as a therapeutic option.

Main Methods:

• A 51-year-old male patient with chronic pancreatitis and recurrent gastrointestinal bleeding was treated.
• Two separate angiographic embolisation procedures were performed 2 years apart.
• Initial embolisation targeted a splenic artery aneurysm; the second targeted a pseudoaneurysm in the pancreatic head.

Main Results:

• The initial splenic artery aneurysm was successfully embolised.
• A subsequent, new pseudoaneurysm in the pancreatic head, fed by an aberrant hepatic artery, was also effectively embolised.
• Follow-up confirmed persistent occlusion of the splenic artery aneurysm and no recurrence of the second pseudoaneurysm at 6 months.

Conclusions:

• Angiographic embolisation is a valid and potentially definitive therapy for metachronous pseudoaneurysms in chronic pancreatitis.
• The procedure is repeatable, offering a viable solution for recurrent bleeding.
• This case demonstrates the successful application of embolisation in managing complex vascular complications of chronic pancreatitis.