An uncommon cause of gastrointestinal bleeding: Pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis

Pseudoaneurysm of the peripancreatic arteries is a typical cause of gastrointestinal bleeding (GIB) in patients with chronic pancreatitis. 1-10% of chronic pancreatitis are associated with an a pseudoaneurysm, especially of the splenic or gastroduodenal artery. Endoscopy often is not successful in finding the cause of bleeding. Sonography: especially color Doppler ultrasound is the best diagnostic tool, indicating the need for celiac angiography. We report on a 59-year-old woman with recurrent severe GIB since 1995. In 1998 another bleeding occurred and sonography showed a pseudoaneurysm of the gastroduodenal artery. Typical criteria are an echofree: pulsatile lesion with an ring-like border. Color Doppler proves a turbulent perfusion inside and shows the feeding vessel. A transcatheter embolization with stainless steel coils was successful, Sis months later the pseudoaneurysm was mainly obliterated.