A Case of Pancretic Pseudocyst Successfully Treated with Transcatheter Arterial Emborization and Endoscopic Pancreatic Drainage via te Papilla of Vater

A 41-year-old man was referred to our hospital for treatment of a large pancreatic pseudocyst. On admission an abdominal computed tomography scan showed an 8-cm pseudocyst in the tail of the pancreas. On the 28th hospital day hypotension suddenly developed, and the patient became unconscious. An enhanced computed tomography scan showed hemorrhage in the pseudocyst. Celiac angiography confirmed bleeding from the splenic artery to the cyst. Transcatheter arterial emobilization was performed. We inserted a catheter in the splenic artery, which was then packed with metallic coils. The hemorrhage of the pseudocyst was stopped, but the pseudocyst did not decrease in size during the next 6 weeks. Therefore, we considered the presence of a communication between the cysts and the main pancreatic duct. A pancreatic duct stent was then placed via the papilla of Vater, and the pancreatic pseudocyst was eliminated.