Therapeutic angioembolization of bleeding pancreaticoduodenal artery pseudoaneurysm following laparoscopy assisted Frey's procedure

Introduction: Minimal access surgery has revolutionized surgery and is considered the gold standard of management for most surgical pathologies of the abdomen. We present a case which to our best knowledge is the first ever report of the non­surgical management of a pancreaticoduodenal artery (PDA) pseudo­ aneurysm following laparoscopy assisted Frey’s procedure (LAFP). Case Report: A 38­year­old male patient was transferred to our hospital due to persistent gastrointestinal bleeding following LAFP. He underwent LAFP for chronic calcific pancreatitis (CCP) two weeks prior to his transfer. Computed tomography angiogram showed the source of bleeding to be a branch of superior pancreaticoduodenal artery (SPDA). The patient was taken to interventional radiology where successful superselective microcoil embolization was performed. We present this rare case of pancreaticoduodenal pseudoaneurysm along with a review of medical literature. Conclusion: A prudent selection of the operative candidate for laparoscopic pancreatic surgery and a high degree of vigilance is imperative to circumvent avoidable morbidity and mortality.