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Pseudocyst formation is a recognised complication of acute pancreatitis. Rarely, they result in pseudoaneurysm formation of neighbouring vessels which can be rapidly fatal if rupture occurs. We report a case of a pseudoaneurysm of the descending thoracic aorta in a mediastinal pancreatic pseudocyst and its management with endovascular prosthetic stent graft. This is the first reported case of a thoracic aortic pseudoaneurysm complicating a thoracic pseudocyst.