Endoscopic ultrasound: a promising approach for the diagnosis of pancreatic pseudoaneurysm

Abstract

Pancreatic pseudoaneurysm converted from a pancreatic pseudocyst is rare but may cause fatal hemorrhage. We report a 42-year-old man with pancreatic pseudocyst in the pancreatic tail which was found by computed tomography in other hospital was referred to our hospital for endoscopic ultrasound(EUS) guided drainage. However, examination by EUS of the pancreas identified a pseudoaneurysm at the level of the pancreatic body, which was represented by a well-defined, 3.5-cm maximal diameter echogenic lesion containing an anechoic area of 1.5 cm with flow detected by Doppler. We immediately terminated the procedure and the patient remained hemodynamically stable. A pseudoaneurysm in the pancreatic tail was detected on contrast-enhanced abdominal computed tomography (CT), which communicated with the splenic artery. A coil embolization of the splenic artery was successfully performed with a favorable outcome. Follow-up contrast-enhanced abdominal CT revealed that the pseudoaneurysm was no longer present. Timely and accurate diagnosis has a great influence on the prognosis of patients with pancreatic pseudoaneurysm. With development of EUS, We do believe that EUS is being an alternative option for the diagnosis of pancreatic pseudoaneurysm.