Embolisation of metachronous pseudoaneurysms complicating chronic pancreatitis.

BACKGROUND: Pseudoaneurysm bleeding is a well-described complication of chronic pancreatitis. Reports of embolisation therapy for metachronous pseudoaneurysms in this condition are rare. We present such a patient and describe his management. CASE OUTLINE: A 5 1-year-old man with chronic pancreatitis who presented with recurrent occult major gastrointestinal bleeding underwent angiography on two separate occasions, 2 years apart. Initial intervention revealed the origin of the coeliac axis to be occluded or absent, and a splenic artery (SA) aneurysm, feeding via the superior mesenteric artery, was embolised. Subsequent angiography after a major bleed showed a new pseudoaneurysm in the head of pancreas feeding from an aberrant hepatic artery, which was embolised. The second angiogram confirmed persistent occlusion of the SA aneurysm and 6 months follow-up showed no evidence of recurrence of the second aneurysm. DISCUSSION: The resolution of these metachronous pseudoaneurysms by angiographic embolisation attests to the validity of this approach as potentially definitive and repeatable therapy.