Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment
Rubens Macedo Arantes, Carlos Andrés Rodriguez Pantanali, Vinicius Rocha Santos, Luiz Augusto Carneiro D’Albuquerque
Liver and Digestive Organ Transplantation Division, Department of Gastroenterology, Clinicas Hospital, University of São Paulo Medical School, São Paulo, SP, Brazil
Am J Case Rep 2017; 18:198-202
Pseudoaneurysm is a rare vascular complication in pancreas transplantation. This complication develops from a disruption of the arterial continuity, usually related to trauma, infection, vasculitis, or complications in vascular procedures.
CASE REPORT: A 43-year-old man underwent simultaneous pancreas and kidney transplantation for end-stage renal disease. He subsequently developed acute pancreatitis and acute kidney cellular rejection as late complications, thus returning to hemodialysis. A new, uneventful kidney transplantectomy and living donor kidney transplant was performed. One year after the last transplant, the patient presented with moderate abdominal pain, fever, and a pulsatile tumor located in the right iliac fossa. A pseudoaneurysm located in the pancreatic Y graft was observed. The patient was treated using an endovascular and surgical approach.
CONCLUSIONS: A combined procedure using an endovascular and surgical approach promoted a good vascular control with a lower risk of bleeding in a rare case of pseudoaneurysm in a transplant patient.
Keywords: Aneurysm, False, endovascular procedures, Pancreas Transplantation