PMC5266204_01
(A) Contrast-enhanced CT scan demonstrates a pseudoaneurysm (asterisk) of the pancreatic tail of 1.2 cm. (B) Contrast-enhaced MRI performed after one month shows an increase in the size of the pseudoaneurysmatic sac.
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An abdominal CT scan revealed a pseudoaneurysm of 1.2 cm in the pancreatic tail, of probable splenic origin (Figure 1A). Magnetic resonance demonstrated an increase in the size of the pseudoaneurysm (Figure 1B).
Selective angiography of the celiac trunk (A) and splenic artery (B) does not demonstrate the perfusion of the pseudo aneurysm. (C) CT scan performed immediately after the diagnostic angiography shows the persistence of the pseudoaneurysm.
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One week later, selective angiography of the celiac trunk, splenic artery and superior mesenteric artery was performed with the aim of embolization; however, the pseudoaneurysm was not demonstrated (Figure 2A, 2B).
Axial scan during CT-guided procedure shows needle position inside the aneurysmatic sac before the injection of thrombin.
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In the supine position and under local anaesthesia, Human thrombin (1,000 IU (2 ml)) was injected percutaneously into the pseudoaneurysmal sac with a 22-G needle (Chibell, Biopsy Bell) (Figure 3).
Contrast - enhanced CT scan performed immediately after thrombin injection shows a complete thrombosis of the pseudoaneurysm in both arterial (A) and portal (B) phases.
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Follow up MRI at 6 months confirms a complete resolution of the aneurysmatic sac.
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