Aortic pseudoaneurysm after pancreatic transplant: Case report and review of the literature

Abstract

Pseudoaneurysm (PSA) is a rare complication of pancreatic transplantation and can present with gastrointestinal (GI) bleeding.We present a case of a 61-year-old male, who had a history of a pancreas transplant for type I diabetes mellitus 12 years ago, who presented with GI bleeding. He had a CT scan that showed a small PSA in the distal aorta near the arterial anastomosis of his previous pancreas transplant. He underwent an angiogram showing a distal aortic PSA with a wide sac. The patient was initially treated with observation and had recurrent bleeding. The patient had a repeat CT scan showing an increase in the size of the aortic pseudoaneurysm with contrast into the GI tract. He underwent an emergent endovascular stent placement with good recovery.Pancreatic transplantations have a low incidence of PSA; however, patients can present with sentinel gastrointestinal bleeding followed by more massive bleeding. These patients should undergo a CT scan with contrast and angiogram for accurate diagnosis and treatment.

Keywords

• Pancreas transplant
• Pseudoaneurysm
• Sentinel bleeding
• CTA