Left Gastric Artery Pseudoaneurysm Due to Pancreatitis

Abstract

Acute or chronic pancreatitis can cause pseudoaneurysms of visceral arteries. The left gastric artery (LGA) is the least common visceral artery being affected. Here, we report a case of chronic pancreatitis with a pseudoaneurysm of the LGA. A 42-year-old male, a chronic alcoholic, and smoker, presented with abdominal pain, haematemesis, and melena. Diagnosis of pseudoaneurysm of LGA aneurysm was confirmed by computed tomography abdomen. The endovascular coil embolization was done successfully, following which the patient had an uneventful recovery.

The Importance of Early Detection and Minimally Invasive Treatment of Pseudoaneurysms Due to Chronic Pancreatitis: Case Report

“…Risk factors for pseudoaneurysm formation include chronic pancreatitis where alcoholism is the underlying etiology, as well as presence of fluid collections, i.e., pseudocyst or WON [10]. Usually, in such patients, melena and hematemesis appear in the clinical course of the disease due to rupture occurrence and upper gastrointestinal bleeding, as Gaur et al described in their article [20]. However, this was not the case with our patient.…”

“…To the best of our knowledge, no previous papers have shown the course of the development of a pseudoaneurysm from its very beginning as a small barely notable outpouching in the proximity of a branch of a left gastric artery to the fully formed pseudoaneurysm within a "walled-off" pancreatic collection. In addition, the left gastric artery is a very rare place of origin for a pseudoaneurysm, and several cases have been published in the literature so far [20].…”

Arterial Pseudoaneurysm Mimicking a Mural Nodule Within a Pancreatic Cyst

“…8,17,18 Pseudoaneurysms within pseudocysts have been associated with hemorrhagic complications in 2.5% of cases and a mortality rate as high as 90%. 17,18 Thus, prophylactic endovascular management is recommended. 19…”

“…16 Pseudoaneurysmal hemorrhage has also been reported with endoscopic drainage of pseudocysts and walledoff pancreatic necrosis. 8,17,18 Pseudoaneurysms within pseudocysts have been associated with hemorrhagic complications in 2.5% of cases and a mortality rate as high as 90%. 17,18 Thus, prophylactic endovascular management is recommended.…”

“… 16 Pseudoaneurysmal hemorrhage has also been reported with endoscopic drainage of pseudocysts and walled-off pancreatic necrosis. 8 , 17 , 18 …”