Successful embolization of pancreaticoduodenal artery pseudoaneurysm in a patient with common hepatic arterial occlusion after modified pancreatoduodenectomy with preservation of arteries in the head of pancreas.

Pancreaticoduodenectomy (PD) with preservation of the arcade in the head of the pancreas was performed in a 73-year-old male with ampullary adenocarcinoma associated with occlusion of the common hepatic artery (CHA) in another hospital. He developed active bleeding from his drain site, at 18 days after the operation. He was transferred to our hospital for emergent embolization. Celiac arteriogram showed complete occlusion of the CHA, posterior superior pancreaticoduodenal artery (PSPDA) pseudoaneurysm 1.7 cm in diameter and development of an enlarged tortuous dorsal pancreatic artery (DPA), posterior pancreatico-duodenal artery (PPDA), and gastroduodenal artery (GDA). Complete hemostasis was obtained without major complications by the transcatheter arterial embolization (TAE) with microcoils.