Management of a large bleeding pancreatic pseudocyst by embolization

Introduction: Hemorrhage from a pancreatic pseudocyst is a rare and often fatal complication of pancreatic trauma and pancreatitis. The pancreatic enzymes can erode into adjacent vessels, resulting intracystic hemorrhage or bleeding into the peritoneal cavity, pancreatic duct, stomach, duodenum, colon, or retroperitoneum. Case Report: We present a case of a large post-traumatic pancreatic pseudocyst in a 17-year-old adolescent, complicated by an intracystic hemorrhage that was successfully treated by selective arterial embolization. Conclusion: A technical refinement both in diagnostic angiography and in transcatheter arterial embolization has strengthened the management of acute pancreatic pseudocyst hemorrhage. The embolization is an effective therapeutic alternative to surgery. A high index of suspicion should be maintained in any patient with a pseudocyst or a history of pancreatic trauma or chronic pancreatitis who presents with the abdominal pain, or falling hemoglobin level. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 6, June 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(6):408–412. www.ijcasereportsandimages.com Tilfine et al. 408 CASE REPORT OPEN ACCESS Management of a large bleeding pancreatic pseudocyst by embolization Charaf Tilfine, Jawad Tadili, Amine Benkabbou, Salwa Bouklata, Nabil Moatassim Billah