Complicated systemic lupus erythematosus pancreatitis: pseudocyst, pseudoaneurysm, but real bleeding.
We report the case of a 25-year-old patient with systemic lupus erythematosus (SLE) pancreatitis which was complicated by pseudocyst and pseudoaneurysm formation. The pseudoaneurysm progressed to intra-abdominal bleeding requiring endovascular coil embolization of the gastroduodenal artery. The pseudocyst and hematoma formed two large abdominal fluid collections causing symptoms due to a mass effect. These fluid collections were treated conservatively, while active SLE was treated with steroids, azathioprine, and immunoglobulins. She finally made a full recovery. To the best of our knowledge, this is the first report of a bleeding pseudoaneurysm complicating SLE pancreatitis. Although anecdotal, this case may serve as a useful example of the possible complications of SLE pancreatitis, including considerations on optimal management.
Departments of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. ejhoorn@gmail.com
E J
EJ
Hoorn
H J
HJ
Flink
E J
EJ
Kuipers
J-W
JW
Poley
P B F
PB
Mensink
R J E M
RJ
Dolhain
D000328:Adult; D017541:Aneurysm, False / Q000473:pathology* / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D010192:Pancreatic Pseudocyst / Q000473:pathology* / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology