title: Hepatic artery pseudoaneurysm caused by acute idiopathic pancreatitis.
abstract: Hepatic artery pseudoaneurysm (HAP) is a very rare disease but in cases of complication, there is a very high mortality. The most common cause of HAP is iatrogenic trauma such as liver biopsy, transhepatic biliary drainage, cholecystectomy and hepatectomy. HAP may also occur with complications such as infections or inflammation associated with septic emboli. HAP has been reported rarely in patients with acute pancreatitis. As far as we are aware, there is no report of a case caused by acute idiopathic pancreatitis, particularly. We report a case of HAP caused by acute idiopathic pancreatitis which developed in a 61-year-old woman. The woman initially presented with acute pancreatitis due to unknown cause. After conservative management, her symptoms seemed to have improved. But eight days after admission, abdominal pain abruptly became worse again. Abdominal computed tomography (CT) was rechecked and it detected a new HAP that was not seen in a previous abdominal CT. Endoscopic retrograde cholangiopancreatography (ERCP) was performed because of a suspicion of hemobilia as a cause of aggravated abdominal pain. ERCP confirmed hemobilia by observing fresh blood clots at the opening of the ampulla and several filling defects in the distal common bile duct on cholangiogram. Without any particular treatment such as embolization or surgical ligation, HAP thrombosed spontaneously. Three months after discharge, abdominal CT demonstrated that HAP in the left lateral segment had disappeared.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Guri, Gyunggi-Do 471-701, South Korea.
authors.forename: Yeon Hwa
authors.initials: YH
authors.lastname: Yu
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Jeong
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Jeon
authors.forename: Min Young
authors.initials: MY
authors.lastname: Kim
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006431:Hemobilia / Q000209:etiology; D006499:Hepatic Artery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014057:Tomography, X-Ray Computed