Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass

Figure 1 Images of the patient. A: Axial unenhanced multi-detector computed tomography (MDCT) shows a soft-tissue mass (arrows) in the area of the uncinate process of the pancreas. There is no sign of calcification or fluid level; B: Sagittal multiplanar reconstruction clearly shows the superior mesenteric artery (arrow) involved in a giant soft-tissue attenuated mass - the hematoma (arrowhead) - at the pancreatic level. After contrast administration, there was no significant enhancement in the hematoma, due to its thrombotic content; C: Magnetic resonance, axial unenhanced gradient echo T1-weighted imaging with fat suppression. The T1 hyperintense perilesional signal (arrows) was caused by the blood content; D: Magnetic resonance cholangiopancreatography (MRCP) shows dilatation of the main pancreatic duct (arrowheads); the choledochus (arrow) was compressed and dislocated, with mild narrowing of the lumen in the distal tract.