Giant Abdominal Pseudoaneurysm Secondary to Recurrent Pancreatitis: Imaging and Endovascular Intervention

Chronic or necrotizing pancreatitis is characterized by repeated inflammation of the pancreas, leading to multiple complications, a few of which are vascular, such as splanchnic venous thrombosis and arterial pseudoaneurysms. Even though the frequency of pseudoaneurysm formation in patients with pancreatitis is as high as 10%, there is not much importance given to its management in the radiologic literature. The splenic artery is the most common visceral artery affected by pseudoaneurysms, followed by the gastroduodenal and pancreaticoduodenal arteries. Usually, pseudoaneurysms occur due to the erosion of a peripancreatic or pancreatic artery into a pseudocyst, but this can also occur without the development of a pseudocyst. Pseudoaneurysms may be asymptomatic (usually the ones less than 5 cm), but some of them may pose a threat due to spontaneous rupture and subsequent fistulization into other organs. Therefore, early diagnosis and management are of prime importance. Here, in this article, we present a case of pseudoaneurysm of the gastroduodenal artery with characteristic imaging features and preferred, recent techniques of management.