Endovascular treatment of a pancreatic artery pseudoaneurysm with arterioportal fistula in chronic pancreatitis: A case report

Miki Yoshida, MD; Kensaku Mori, MD; Sakiko Shigeta, MD; Masaomi Nagase, MD; Kazunori Ishige, MD; Kuniaki Fukuda, MD; Masato Endou, MD; Tsukasa Saida, MD; Takahito Nakajima, MD

Radiology Case Reports (Nov 2024)

Endovascular treatment of a pancreatic artery pseudoaneurysm with arterioportal fistula in chronic pancreatitis: A case report

Miki Yoshida, MD,
Kensaku Mori, MD,
Sakiko Shigeta, MD,
Masaomi Nagase, MD,
Kazunori Ishige, MD,
Kuniaki Fukuda, MD,
Masato Endou, MD,
Tsukasa Saida, MD,
Takahito Nakajima, MD

Affiliations

Miki Yoshida, MD: Department of Diagnostic and Interventional Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan; Corresponding author.
Kensaku Mori, MD: Department of Radiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo 135-8550, Japan
Sakiko Shigeta, MD: Department of Gastroenterology and Hepatology, Tsukuba Gakuen Hospital, 2573-1, Kamiyokoba, Tsukuba, Ibaraki 305-0854, Japan
Masaomi Nagase, MD: Department of Gastroenterology and Hepatology, Tsukuba Gakuen Hospital, 2573-1, Kamiyokoba, Tsukuba, Ibaraki 305-0854, Japan
Kazunori Ishige, MD: Department of Gastroenterology and Hepatology, Tsukuba Gakuen Hospital, 2573-1, Kamiyokoba, Tsukuba, Ibaraki 305-0854, Japan
Kuniaki Fukuda, MD: Department of Gastroenterology and Hepatology, Tsukuba Gakuen Hospital, 2573-1, Kamiyokoba, Tsukuba, Ibaraki 305-0854, Japan
Masato Endou, MD: Department of gastroenterology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
Tsukasa Saida, MD: Department of Diagnostic and Interventional Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Takahito Nakajima, MD: Department of Diagnostic and Interventional Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan

Journal volume & issue: Vol. 19, no. 11
pp. 5257 – 5261

Abstract

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Arterioportal fistula (APF) combined with a visceral artery pseudoaneurysm is an exceptionally rare and critical vascular disorder of the abdominal viscera, with pseudoaneurysm rupture being potentially fatal and severe APF leading to portal hypertension, both of which necessitate immediate intervention. An 87-year-old woman with a history of pancreatitis presented with upper abdomen and back pain. Laboratory tests revealed elevated amylase levels and severe anemia. A computed tomography (CT) scan showed a large dorsal pancreatic artery (DPA) pseudoaneurysm with a fistula to the main portal vein. Given her advanced age, surgery was deemed high-risk, and endovascular treatment was selected. Transcatheter arterial embolization was successfully performed using coils to embolize the DPA pseudoaneurysm. A follow-up CT 1 week postprocedure confirmed the absence of a pseudoaneurysm and no further progression of anemia.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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