Chronic Pancreatitis Complicated by Pseudoaneurysm Causing Gastrointestinal Bleeding

TL;DR

A woman with chronic pancreatitis experienced a gastrointestinal bleed caused by a pseudoaneurysm, which was successfully treated with coil embolization.

Contribution

This case highlights the rare but serious complication of pseudoaneurysm in chronic pancreatitis and its management.

Findings

Chronic pancreatitis can lead to pseudoaneurysm formation in the celiac trunk branches.

A left gastric artery pseudoaneurysm was identified as the source of gastrointestinal bleeding.

Coil embolization effectively stabilized the patient's condition and allowed for discharge.

Abstract

Patients with chronic pancreatitis frequently present with acute flares, which can lead to a variety of complications due to the underlying inflammation. Chronic pancreatitis leads to an inflammatory cascade, possibly leading to pseudoaneurysm formation. Due to its location, the branches of the celiac trunk are the most commonly affected arteries. The pseudoaneurysm can lead to a gastrointestinal bleed. Identification of these pseudoaneurysms early on in the clinical course is crucial to providing the appropriate management, as not all medical centers may be equipped with capabilities for artery coil embolization. In the present case, a female in her 50s presented for an acute flare of her chronic pancreatitis. During her hospitalization, she had an acute drop in her hemoglobin, prompting upper endoscopy by gastroenterology services to locate the source. Blood was visualized in the duodenum but without a clear source. A computed tomography angiography was performed, and a left gastric artery pseudoaneurysm was noted. The patient underwent coil embolization of the left gastric pseudoaneurysm. The patient’s hemoglobin levels stabilized post-procedure and was able to be discharged soon after the procedure.

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