Embolization of a large pancreatic pseudoaneurysm converted from pseudocyst (hemorrhagic pseudocyst).

CONTEXT: Bleeding pancreatic pseudoaneurysms are a rare complication of chronic pancreatitis with a severe prognosis and high mortality. Conversion of a pancreatic pseudocyst into a pseudoaneurysm is a potentially lethal complication because, when rupture occurs, there is a high mortality rate. CASE REPORT: We describe a case of pancreatic pseudoaneurysm converted from a pseudocyst. A 57-year-old man with chronic pancreatitis and alcoholic liver cirrhosis presented with abdominal pain in the upper epigastric region. CT and a selective angiogram of the superior mesenteric artery showed a large bleeding pancreatic pseudoaneurysm. The pseudoaneurysm was successfully treated with coil embolization of the feeding artery. CONCLUSION: Endovascular trans-catheter embolization for the treatment of pancreatic pseudoaneurysms is a safe, effective and repeatable procedure with high success rates and it should be used as a treatment of choice in appropriate patients, either as a temporizing measure to control active bleeding and allow hemodynamic stabilization for a surgical procedure or as a definitive treatment.

Spontaneously ruptured gastrointestinal stromal tumor (GIST) of the jejunum mimicking acute appendicitis.

Gastrointestinal stromal tumors (GISTs) are characterized with diverse clinical presentations, including acute and chronic gastrointestinal bleeding, abdominal pain, presence of an intra-abdominal mass, anorexia, and intestinal obstruction. A 60-year-old obese woman presented as an acute abdominal emergency with right lower quadrant (RLQ) pain and tenderness, nausea and leukocytosis, all mimicking acute appendicitis. Laparotomy revealed a spontaneously ruptured GIST of the jejunum, which was localized to the RLQ due to postoperative adhesions following previous two cesarean sections and cholecystectomy. Complete surgical resection was performed, followed by an uneventful early postoperative course.