Case Report
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World J Gastroenterol. May 14, 2012; 18(18): 2291-2294
Published online May 14, 2012. doi: 10.3748/wjg.v18.i18.2291
Hepatic artery pseudoaneurysm caused by acute idiopathic pancreatitis
Yeon Hwa Yu, Joo Hyun Sohn, Tae Yeob Kim, Jae Yoon Jeong, Dong Soo Han, Yong Cheol Jeon, Min Young Kim
Yeon Hwa Yu, Joo Hyun Sohn, Tae Yeob Kim, Jae Yoon Jeong, Dong Soo Han, Yong Cheol Jeon, Department of Internal Medicine, Hanyang University College of Medicine, Guri, Gyunggi-Do 471-701, South Korea
Min Young Kim, Department of Radiology, Hanyang University College of Medicine, Guri 471-701, South Korea
Author contributions: Yu YH, Sohn JH and Kim TY made substantial contributions to conception and design; Jeong JY, Han DS and Jeon YC contributed to endoscopic procedures; Kim MY provided discussion of the radiology; Yu YH wrote the paper; and all authors approved the version to be published.
Correspondence to: Joo Hyun Sohn, MD, Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomun-Dong, Guri, Gyunggi-Do 471-701, South Korea.
Telephone: +82-31-5602225 Fax: +82-31-5552998
Received: August 19, 2011
Revised: November 28, 2011
Accepted: March 10, 2012
Published online: May 14, 2012

Hepatic artery pseudoaneurysm (HAP) is a very rare disease but in cases of complication, there is a very high mortality. The most common cause of HAP is iatrogenic trauma such as liver biopsy, transhepatic biliary drainage, cholecystectomy and hepatectomy. HAP may also occur with complications such as infections or inflammation associated with septic emboli. HAP has been reported rarely in patients with acute pancreatitis. As far as we are aware, there is no report of a case caused by acute idiopathic pancreatitis, particularly. We report a case of HAP caused by acute idiopathic pancreatitis which developed in a 61-year-old woman. The woman initially presented with acute pancreatitis due to unknown cause. After conservative management, her symptoms seemed to have improved. But eight days after admission, abdominal pain abruptly became worse again. Abdominal computed tomography (CT) was rechecked and it detected a new HAP that was not seen in a previous abdominal CT. Endoscopic retrograde cholangiopancreatography (ERCP) was performed because of a suspicion of hemobilia as a cause of aggravated abdominal pain. ERCP confirmed hemobilia by observing fresh blood clots at the opening of the ampulla and several filling defects in the distal common bile duct on cholangiogram. Without any particular treatment such as embolization or surgical ligation, HAP thrombosed spontaneously. Three months after discharge, abdominal CT demonstrated that HAP in the left lateral segment had disappeared.

Keywords: Hepatic artery, Pseudoaneurysm, Pancreatitis, Acute, Hemobilia