False aneurysm of the pancreaticoduodenal artery complicating therapeutic endoscopic retrograde cholangiopancreatography.
A 76-year-old woman underwent two endoscopic retrograde cholangiopancreatography (ERCP) procedures for palliation of a carcinoma of the pancreas. At the first procedure a pre-cut sphincterotomy was performed because deep cannulation of the biliary tree was impossible. An endoscopic plastic biliary stent was inserted at the second ERCP. The patient developed abdominal pain and a post-procedure CT demonstrated a pseudoaneurysm. This was not present on the pre-procedure CT and was thought to arise from the pancreaticoduodenal artery as a complication of the pre-cut sphincterotomy. Visceral angiography confirmed the origin of the aneurysm from a branch of the inferior pancreaticoduodenal artery. The aneurysm was successfully embolised. To our knowledge, this is the first time that this complication has been reported.
al-Jeroudi
A
A
Department of Radiology, Central Middlesex Hospital, Acton Lane, London NW10 7NS, UK.
Belli
A M
AM
Shorvon
P J
PJ
D000368:Aged; D017541:Aneurysm, False / Q000209:etiology*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D004386:Duodenum / Q000098:blood supply*; D005260:Female; D006801:Humans; D010179:Pancreas / Q000098:blood supply*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*