RESUMEN
Jejunal pseudoaneurysm is a rare complication of pancreatitis, usually manifested by digestive bleeding when it ruptures into the digestive lumen. This complication is extremely rare and may be life-threatening. The diagnosis is based on abdominal angiographic computed tomography. Radiology allows therapeutic management through arterial embolization. This case report describes a pseudoaneurysm of jejunal artery that developed as the result of pancreatitis: A 77-year-old man seen in early September 2015 at the emergency department for acute pancreatitis had a pseudocyst infected and spontaneously fistulized into the jejunum lumen. His condition responded initially to symptomatic therapy, and he was discharged. He returned two years later, with digestive bleeding from jejunal pseudoaneurysm that had ruptured into the jejunal lumen. Angiographic embolization was performed as first-line treatment with good outcome. Bleeding more than two years after acute pancreatitis due to rupture of a jejunal pseudoaneurysm is an exceptional complication. Here we report a rare case of digestive hemorrhage caused by jejunal pseudoaneurysm, complicating acute pancreatitis.
Asunto(s)
Aneurisma Falso/etiología , Aneurisma Roto/etiología , Arterias , Yeyuno/irrigación sanguínea , Pancreatitis/complicaciones , Anciano , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/terapia , Arterias/diagnóstico por imagen , Embolización Terapéutica , Hemorragia Gastrointestinal/etiología , Humanos , Masculino , Pancreatitis/diagnóstico , Resultado del TratamientoRESUMEN
We report here a case of aorto-cava fistula complicating the rupture of a sub-renal aortic aneurysm into the inferior vena cava, which is a rare complication of aortic abdominal aneurysms with often-fatal outcome. Abdominal computed tomography with multi-planar reconstructions remains the firstline-imaging tool allowing positive diagnosis and preoperative planning. Treatment may be surgical or endovascular.