Gastroepiploic artery pseudoaneurysm embolization

Case contributed by Javad Jalili

Presentation

Work up for abdominal pain.

Patient Data

Age: 60 years
Gender: Female

The pancreas is edematous, and peripancreatic fat stranding is evident, compatible with pancreatitis.

There is a smooth margin hyperattenuating mass-like lesion with surrounding hematoma near the gastric greater curvature, which maintains the intravenous contrast in delayed images. The diameter of the lesion is more than its related artery, so that's a pseudoaneurysm of the left gastroepiploic artery regarding enhancement pattern and anatomical location.

Moderate free abdominopelvic fluid due to hemorrhage.

Contrast outpouching at left gastroepiploic artery compatible with pseudoaneurysm.

Successful embolization was done.

Case Discussion

Visceral artery aneurysms include both true aneurysms and pseudoaneurysms. Incidence is approximately 0.01% to 2% in autopsy and angiographic studies, with over half of the cases involving splenic artery aneurysms.

Most patients are asymptomatic and usually discovered incidentally, less frequently associated with abdominal pain, or palpable as a pulsatile mass in the abdomen. Up to 25% may be complicated by rupture. Early diagnosis is necessary for immediate intervention and to save patients' lives.

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