Case Report

Major abdominal haemorrhage following total pancreatectomy. How late can it be?

William Howden, Sam Alhayo, Ross Copping, Prabha Ramesh Damodaran, Yehia El Hgar and Amitabha Das
World Journal of Medical and Surgical Case Reports 2021, 10:2

Abstract

Introduction

This report presents the second case and most delayed case to-date of a ruptured pseudoaneurysm following-total pancreatectomy. Pseudoaneuryms post-partial pancreatoduodenectomy are a rare, but well documented event. A ruptured pseudoaneurysm following total pancreatectomy is extremely uncommon, and without a clear pathophysiological mechanism.

Case description

A 60 year old male presents to ED moribund following acute onset abdominal pain, 321 days post total pancreatectomy. A multi-phase CT scan demonstrated a large ruptured pseudoaneurysm in the periportal area. The patient is resuscitated, receiving 16 units of packed red blood cells and the aneurysm is embolised by interventional radiology and makes a full recovery after recovering in intensive care before being discharged two weeks later.

Conclusion

This case highlights the need for the treating doctor to consider post-pancreatectomy haemorrhage in any total pancreatectomy patient, even without remnant pancreatic parenchyma and almost a year post-operatively.

Keywords

Pseudoaneurysm, angioembolisation

Download PDF    Full Text