Successful endovascular treatment of post-traumatic inferior pancreaticoduodenal artery pseudoaneurysm

Leong BDK, Chuah JA, Kumar VM, Mazri MY, Zainal AA
Correspondence: Dr Benjamin Leong Dak Keung, bleongdk@yahoo.com

ABSTRACT
True and pseudoaneurysms of the visceral arteries are uncommon. They represent 0.1-0.2 percent of all vascular aneurysms. Visceral artery aneurysms (VAAs) should be treated due to their propensity to rupture and associated high mortality. We describe a 58-year-old man with pseudoaneurysm of the inferior pancreaticoduodenal artery and who presented with post-motor vehicle accident abdominal pain and a pulsatile epigastic mass. Computed tomography (CT) showed a pseudoaneurysm of the visceral artery, and selective mesenteric angiography showed the aneurysm to be arising from the inferior pancreaticoduodenal artery. The aneurysm was successfully treated with endovascular coil embolisation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. To the best of our knowledge, this is the first reported pseudoaneurysm of inferior pancreaticoduodenal artery secondary to blunt abdominal trauma from a motor vehicle accident and also the first reported VAA from Malaysia.

Keywords: endovascular embolisation, inferior pancreaticoduodenal artery, motor vehicle accident injury, pseudoaneurysm, visceral artery aneurysm
Singapore Med J 2008; 49(11): e300-e302