case_images: PMC10623810_01
case_images: CT abdomen without intravenous contrast (axial and coronal sections) showing peripancreatic inflammation surrounding the pancreatic body and head along with retroperitoneal bleed (red arrow).
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case_images: PMC10623810_01_crg-2023-0017-0001-533617_F01.jpg
case_images: F1
case_images: CT abdomen and pelvis without intravenous contrast showed evidence of hemorrhagic pancreatitis centered at pancreatic head along with large volume of blood in retroperitoneal space, reactive inflammatory changes of the adjacent duodenum, para-aortic and common iliac lymphadenopathy, and fluid-filled distention of the stomach and esophagus suspicious for gastric outlet obstruction (Fig. 1).
case_images: CT angiography of abdomen (axial and coronal) in arterial phase showing retroperitoneal and right-sided intraperitoneal hemorrhage (red arrow) with active contrast extravasation (yellow arrows) suspicious for arterial bleeding versus punctuate pseudoaneurysm.
case_images: crg-2023-0017-0001-533617_F02.jpg
case_images: PMC10623810_01_crg-2023-0017-0001-533617_F02.jpg
case_images: F2
case_images: CT angiography was obtained given the clinical picture which showed an enlarging retroperitoneal and right-sided intraperitoneal hematoma with suspicion for active arterial extravasation or punctate pseudoaneurysms in the pancreatic head (Fig. 2). Celiac angiogram was done under fluoroscopic guidance, which showed gastroduodenal and superior pancreaticoduodenal artery pseudoaneurysms (Fig. 3).
case_images: Celiac artery angiogram (pre-embolization) showing pseudoaneurysm (yellow arrows) involving gastroduodenal and superior pancreaticoduodenal artery.
case_images: crg-2023-0017-0001-533617_F03.jpg
case_images: PMC10623810_01_crg-2023-0017-0001-533617_F03.jpg
case_images: F3
case_images: CT angiography was obtained given the clinical picture which showed an enlarging retroperitoneal and right-sided intraperitoneal hematoma with suspicion for active arterial extravasation or punctate pseudoaneurysms in the pancreatic head (Fig. 2). Celiac angiogram was done under fluoroscopic guidance, which showed gastroduodenal and superior pancreaticoduodenal artery pseudoaneurysms (Fig. 3).
case_images: Celiac artery angiogram post embolization showing microcoils (yellow arrow) in the GDA, resulting in complete stasis of flow to the artery and its branches.
case_images: crg-2023-0017-0001-533617_F04.jpg
case_images: PMC10623810_01_crg-2023-0017-0001-533617_F04.jpg
case_images: F4
case_images: Gastroduodenal artery (GDA) embolization was carried out using microcoils and gel foam via the right common femoral artery approach (Fig. 4).