Successful treatment for rupture of pancreaticoduodenal artery aneurysm : Two case reports

We report 2 cases of ruptured pancreaticoduodenal artery aneurysm (PDAA) treated by transcatheter embolization (TAE). In the first case, a 63-year-old man complained of sudden abdominal pain and was transferred to our hospital because he collapsed in a state of shock. Abdominal computed tomography (CT) revealed retroperitoneal hematoma and ascites. Abdominal angiography showed bleeding from one of the branches of the inferior pancreaticoduodenal artery. The ruptured PDAA was terminated by TAE. In the second case, a 65-year-old man experienced sudden abdominal pain. Abdominal CT revealed a retroperitoneal hematoma. He received TAE to terminate bleeding from a PDAA, but his abdominal pain worsened. At operation, ileus caused by the hematoma compressing the transverse colon was diagnosed, and cecostomy was performed. He recovered well and was discharged a few days later. In summary, a patient with a ruptured PDAA should first be treated by TAE, followed if necessary by surgery.