Endovascular exclusion of a ruptured pseudoaneurysm of the infrarenal abdominal aorta secondary to pancreatitis.
OBJECTIVE
To report the successful repair of a ruptured pseudoaneurysm of the infrarenal abdominal aorta secondary to pancreatitis.


METHODS
A 47-year-old man was admitted with abdominal pain due to an acute exacerbation of chronic alcoholic pancreatitis. He was found to have an infrarenal abdominal aortic aneurysm, which was confirmed by spiral computed tomography (CT), but there had been no evidence of aneurysm formation on a scan performed 1 year previously. Persistent symptoms prompted a further CT scan 48 hours later; this revealed evidence of a ruptured infrarenal abdominal aortic pseudoaneurysm. The pseudoaneurysm was excluded using a Zenith aortomonoiliac endovascular graft. Recovery was uneventful, and the patient underwent pancreatic resection 6 months later. A duplex scan 10 months after endograft placement could not identify an aneurysm sac.


CONCLUSIONS
In selected cases, endovascular repair provides a useful method of excluding ruptured aortic pseudoaneurysms due to pancreatitis. It allows hemorrhage control in a potentially infected operative field and permits elective pancreatic resection. Prolonged follow-up is mandatory to ensure there is no evidence of graft sepsis and that aneurysm exclusion is maintained.
Hinchliffe
Robert J
RJ
Department of Vascular and Endovascular Surgery, University Hospital, Nottingham, England, UK. robhinchliffe@hotmail.com
Yung
Ming
M
Hopkinson
Brian R
BR
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging; D015607:Stents; D014057:Tomography, X-Ray Computed