Postpancreatectomy hemorrhage (PPH) is a severe complication of pancreatic surgery. This condition often develops on the background of pancreatic fistula. In our report, we demonstrate an unusual case of spontaneous cessation of severe postpancreatectomy common hepatic artery (СHA) hemorrhage after distal pancreatectomy in a patient with celiac artery stenosis (CAS). A 64-year-old male diagnosed with pancreatic tail tumor underwent extended distal pancreatectomy. He developed pancreatic fistula and was discharged with an abdominal drain, and was readmitted with severe postpancreatectomy hemorrhage from a pseudoaneurysm of the CHA. The bleeding stopped spontaneously due to CHA thrombosis. The patient developed no ischemic symptoms. Spontaneous severe postpancreatectomy hemorrhage cessation is an extremely rare phenomenon. Vascular anomalies must be considered when attempting interventional radiology treatment. CHA probably may be sacrificed with no ischemic consequences in case of severe hemorrhage in patients with CAS.
Keywords: CAS, celiac artery stenosis; CBC, complete blood count; CHA, common hepatic artery; CT, computed tomography; Case report; Celiac artery stenosis; Distal pancreatectomy; IR, interventional radiology; NSAIDs, nonsteroidal anti-inflammatory drugs; PPH, postpancreatectomy hemorrhage; Pancreatic fistula; Postpancreatectomy hemorrhage; Pseudoaneurysm; RHA, right hepatic artery; SMA, superior mesenteric artery; US, ultrasound.
© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.