PMC5080637_01
The first CECT scan revealed a severe acute pancreatitis. Any images related to a right gastric artery pseudoaneurysm were present.
gr1.jpg
PMC5080637_01_gr1.jpg
fig0005
At admission, the laboratory results (neutrophilic leukocytosis: 41.51 x 10^3/mul total white blood cells with 37.07 x 10^3/mul neutrophil; amylases: 251 U/L; lipases: 816 U/L; C-reactive protein: 34.1 mg/dl; procalcitonine: 10.93 ng/ml) and the CECT (Fig. 1) reveled an acute severe pancreatitis, which involved the whole pancreatic gland and presented peripancreatic, perihepatic and perisplenic free fluid, with a modified CT severity index of 8 (range 0-10).
a Control CECT after 13 days from acute pancreatitis onset revealed the presence of a 7 mm pseudoaneurysm of the right gastric artery (arrow). b 3D reconstruction of Aorta and its principal branches (celiac trunk and superior mesenteric artery).
gr2.jpg
PMC5080637_01_gr2.jpg
fig0010
It revealed an organized fluid collection of 11 x 6.5 cm in the body of the pancreas and the appearance of a 7 mm pseudoaneurysm of the right gastric artery inside the collection (Fig. 2 a-b).
Selective angiography of celiac trunk and of superior mesenteric artery showed a pseudoaneurysm localized in a branch of the right gastric artery and in a branch of the posterior superior pancreaticoduodenal artery.
gr3.jpg
PMC5080637_01_gr3.jpg
fig0015
Selective angiography of celiac trunk and of superior mesenteric artery showed a pseudoaneurysm localized not only in a branch of the right gastric artery, but also in a branch of the posterior superior pancreaticoduodenal artery (Fig. 3).
Selective angiography of celiac trunk after pseudoaneurysm coil embolization.
gr4.jpg
PMC5080637_01_gr4.jpg
fig0020