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British Journal of Radiology 74 (2001),375-377 © 2001 The British Institute of Radiology

Case report

False aneurysm of the pancreaticoduodenal artery complicating therapeutic endoscopic retrograde cholangiopancreatography

A Al-Jeroudi, MD 1 A-M Belli, MB BS, FRCR 2 and P J Shorvon, MRCP, FRCR 1

1 Department of Radiology, Central Middlesex Hospital, Acton Lane, London NW10 7NS 2 Department of Diagnostic Radiology, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK

Correspondence: Dr P J Shorvon

A 76-year-old woman underwent two endoscopic retrograde cholangiopancreatography (ERCP) procedures for palliation of a carcinoma of the pancreas. At the first procedure a pre-cut sphincterotomy was performed because deep cannulation of the biliary tree was impossible. An endoscopic plastic biliary stent was inserted at the second ERCP. The patient developed abdominal pain and a post-procedure CT demonstrated a psuedoaneurysm. This was not present on the pre-procedure CT and was thought to arise from the pancreaticoduodeal artery as a complication of the pre-cut sphincterotomy. Visceral angiography confirmed the origin of the aneurysm from a branch of the inferior pancreaticoduodenal artery. The aneurysm was successfully embolised. To our knowledge, this is the first time that this complication has been reported.




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