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Clinical Observation |

Visceral Artery Pseudoaneurysms Following Pancreatoduodenectomy

Eseroghene Otah, MD; Brian J. Cushin, MD; Grigory N. Rozenblit, MD; Richard Neff, MD; Kenneth E. Otah, MD; Avram M. Cooperman, MD
Arch Surg. 2002;137(1):55-59. doi:10.1001/archsurg.137.1.55.
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Pancreatic and biliary fistulas and delayed gastric emptying are the most common complications after pancreatoduodenectomy. The development and bleeding of visceral arterial pseudoaneurysms are rare phenomena and pose diagnostic and treatment dilemmas. We describe 5 recent patients who developed bleeding from visceral artery pseudoaneurysms after pancreatoduodenectomy. These patients all had "herald" bleeding from their abdominal drains. Subsequent angiography and therapeutic embolizations were successfully performed.

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Figure 1.

A 2.0-cm visceral arterial pseudoaneurysm of a gastroduodenal artery stump (arrow).

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Figure 2.

Obliteration of the gastroduodenal artery stump pseudoaneurysm shown in Figure 1 after successful coil embolization.

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Figure 3.

A 2.0-cm visceral arterial pseudoaneurysm of an accessory right hepatic artery (arrow). This accessory hepatic artery originated from the superior mesenteric artery.

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Figure 4.

Obliteration of the accessory right hepatic artery pseudoaneurysm shown in Figure 3 after coil embolization.

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