Cystic artery pseudoaneurysm following acute necrotising pancreatitis.
Manoj Thillai, Pulkit Sethi, Ramachandran Narayana Menon, Nazar Puthukudiyil Kader
Author Information
Manoj Thillai: Department of Surgical Gastroenterology and Liver transplantation, Amrita Institute of Medical sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India. ORCID
Pulkit Sethi: Department of Surgical Gastroenterology and Liver transplantation, Amrita Institute of Medical sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India.
Ramachandran Narayana Menon: Department of Surgical Gastroenterology and Liver transplantation, Amrita Institute of Medical sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India.
Nazar Puthukudiyil Kader: Department of Radiodiagnosis, Amrita Institute of Medical Sciences, Amrita vishwavidyapeetham, Ponekkara, Kochi, Kerala, India.
Cystic artery pseudoaneurysm is a rare pathology. Of the 20 cases reported so far, chronic cholecystitis and iatrogenic biliary injury form the majority of causes. Currently, there is no published report of such pseudoaneurysms caused secondary to pancreatitis, hence the management in such a scenario is unclear. We hereby present the first such report of cystic artery pseudoaneurysm occurring as a sequel of acute necrotising pancreatitis. A 33-year-old man who recovered from a recent attack of acute pancreatitis was readmitted for melena and fever. Computed tomography of abdomen revealed blood in the gall bladder with pericholecystic blush and resolving pancreatic necrosis. Percutaneous transarterial embolisation of the cystic artery was done. This stabilised the patient but persistent sepsis and clinical deterioration warranted a surgical exploration and cholecystostomy. Hence, transarterial embolisation followed by surgery in selected cases can be an ideal management protocol.
