Endovascular management of a pancreaticoduodenal aneurysm: a clinical dilemma.

Objective: To report the successful endovascular embolization of a pancreaticoduodenal aneurysm (PDA).

Methods: A 56-year-old man with a history of pancreatitis presented with insidious, progressive epigastric pain for the preceding 6 months. Contrast-enhanced computed tomography (CT) and selective hepatic digital subtraction angiography identified a 7.7-cm aneurysm that arose from the pancreaticoduodenal branch of the gastroduodenal artery. Through a percutaneous common femoral approach, 10 stainless steel coils were delivered to occlude the aneurysm. A single coil detached and became lodged in a small branch of the right hepatic artery without sequelae. At 26 months, duplex and CT scans show continued occlusion of the aneurysm.

Conclusions: Transcatheter coil embolization should be the first choice treatment for aneurysms of the pancreaticoduodenal artery.