The CT-guided percutaneous drainage of pancreatic pseudocyst accompanied by pseudoaneurysm: A case report.

RATIONALE: This case report discusses the CT-guided percutaneous drainage of a pancreatic pseudocyst accompanied by a pseudoaneurysm. Pancreatic pseudocysts can erode the peripancreatic artery and produce pseudoaneurysms. This is rare, but it can be life-threatening. PATIENT CONCERNS: The case presented involves a 58-year-old female who was diagnosed with pancreatic cancer and underwent surgical treatment. She presented with hematochezia, dizziness, and hypodynamic findings with no obvious cause. Imaging revealed a pancreatic pseudocyst and small arterial aneurysms. To reduce the risk of aneurysm rupture, the patient underwent transcatheter arterial coil embolization. Three days later, CT-guided catheter drainage was performed to reduce the erosion of the arterial wall caused by pancreatic fluid. DIAGNOSES: The contrast-enhanced-CT imaging showed a round, slightly high-density lesion in the cyst, suggesting the presence of a pseudoaneurysm. INTERVENTIONS: The patient was sent for another transcatheter arterial embolization with coils and n-butyl-2-cyanoacrylate. OUTCOMES: After receiving the transcatheter arterial embolization, the patient had no serious bleeding or other complications. LESSONS: Early detection and accurate assessment of pseudoaneurysms are essential for appropriate management. This case shows that contrast-enhanced CT is necessary before CT-guided percutaneous drainage of pancreatic pseudocysts. It also shows that, due to the many complications that pancreatic pseudocysts may cause, appropriate treatment of pseudocysts complicated with pseudoaneurysm has important clinical significance.

MR Imaging of Migrated Nucleus Pulposus after Collagenase Injection of Lumbar Disc Herniation: A Case Report.

Magnetic resonance images (MRI) of migrated nucleus pulposus after collagenase treatment of lumbar disc herniation are rarely published. Here, we describe a 65-year-old woman with L5-S1 intervertebral disc herniation on the rear left. The patient was treated with a lumbar disc collagenase injection, and the pain was relieved. Two weeks later, the patient suddenly developed pain again after engaging in weight-bearing activity. Lumbar MRI showed a nodule in the spinal canal at the L5-S1 level. The patient underwent surgical treatment two days later. Pathology showed that the nodule was nucleus pulposus tissue. Teaching point: It is important to understanding the MR manifestations of migrated nucleus pulposus after collagenase treatment to prevent such misdiagnosis.