Pancreatitis with delayed GI bleed or new pain, suspected splenic artery pseudoaneurysm
Recommended: CTA Abdomen is the preferred imaging study for pancreatitis with delayed gi bleed or new pain, suspected splenic artery pseudoaneurysm. Erosion of pancreatic pseudocyst into splenic artery.
Recommended study
CTA Abdomen
Erosion of pancreatic pseudocyst into splenic artery. High rupture risk — embolize even if small.
If the default doesn't apply
Treatment
IR for embolization or stent grafting
IV contrast
Watch-outs
Treat regardless of size
Pseudoaneurysms (unlike true aneurysms) carry high rupture risk; embolize all in pancreatitis context.
Pearls
- Yin-yang sign on color Doppler if accessible via US.
- Hemosuccus pancreaticus: bleeding into pancreatic duct → into duodenum; intermittent GI bleeding.
- Gastroduodenal artery pseudoaneurysm also common in pancreatitis.