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CASE REPORT
Cystic artery pseudoaneurysm following acute necrotising pancreatitis
  1. Manoj Thillai1,
  2. Pulkit Sethi1,
  3. Ramachandran Narayana Menon1,
  4. Nazar Puthukudiyil Kader2
  1. 1 Department of Surgical Gastroenterology and Liver transplantation, Amrita Institute of Medical sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India
  2. 2 Department of Radiodiagnosis, Amrita Institute of Medical Sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India
  1. Correspondence to Dr Pulkit Sethi, drpulkitsethi{at}gmail.com, pulkit_sethi29{at}gmail.com

Summary

Cystic artery pseudoaneurysm is a rare pathology. Of the 20 cases reported so far, chronic cholecystitis and iatrogenic biliary injury form the majority of causes. Currently, there is no published report of such pseudoaneurysms caused secondary to pancreatitis, hence the management in such a scenario is unclear. We hereby present the first such report of cystic artery pseudoaneurysm occurring as a sequel of acute necrotising pancreatitis. A 33-year-old man who recovered from a recent attack of acute pancreatitis was readmitted for melena and fever. Computed tomography of abdomen revealed blood in the gall bladder with pericholecystic blush and resolving pancreatic necrosis. Percutaneous transarterial embolisation of the cystic artery was done. This stabilised the patient but persistent sepsis and clinical deterioration warranted a surgical exploration and cholecystostomy. Hence, transarterial embolisation followed by surgery in selected cases can be an ideal management protocol.

  • GI bleeding
  • Pancreatitis
  • Pancreas and biliary tract
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Footnotes

  • Contributors MT conceived of the case. MT and PS initiated the study design. RM and NPK helped with implementation. All the authors contributed to refinement of the case reporting protocol and approved the final manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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