# Emergency Management of Post-Pancreatectomy Hemorrhage Secondary to a Ruptured Common Hepatic Artery Pseudoaneurysm: A Case Report

## TL;DR

This case report describes a rare but life-threatening complication following a pancreatoduodenectomy, highlighting the importance of rapid diagnosis and treatment of post-pancreatectomy hemorrhage.

## Contribution

The novelty lies in presenting a rare clinical case of delayed post-pancreatectomy hemorrhage due to a ruptured common hepatic artery pseudoaneurysm.

## Key findings

- A ruptured common hepatic artery pseudoaneurysm can present as a sentinel bleed following pancreatoduodenectomy.
- Emergency endovascular interventions are critical for managing delayed post-pancreatectomy hemorrhage.
- Emergency physicians should be aware of the signs and treatment options for this rare but deadly complication.

## Abstract

Post-pancreatectomy hemorrhage (PPH) is a deadly complication of pancreatectomy procedures. Rapid identification of these life-threatening complications is crucial to mitigating associated morbidity and mortality rates. Delayed PPH is managed similarly to aortoenteric fistulas with damage control resuscitation and emergent endovascular interventions such as embolization and stent placement.

Here, we present the case of a delayed PPH presenting to the emergency department as a sentinel bleed secondary to a ruptured common hepatic artery pseudoaneurysm following a pancreatoduodenectomy.

With hepatobiliary procedures being performed with more frequency, emergency physicians must be aware of the deadly postoperative complications such as post-pancreatectomy hemorrhage, their presentations, and their treatments.