Delayed Pseudoaneurysm Rupture and Management After Covered Stent Placement for Post Pancreaticoduodenectomy Hemorrhage

The development of a pseudoaneurysm following Fluency®Plus-covered stent placement for post-Whipple operation bleeding has not been reported. A 79 year-old man diagnosed with pancreas head cancer received Whipple operation and suffered from subsequent gastroduodenal artery stump bleeding. The hemorrhage was treated successfully by covered stent placement at the common hepatic artery. However, two episodes of pseudoaneurysm formation at the proximal stent edge occurred successively in the follow-up period and were treated with endovascular managements. Sequential development of pseudoaneurysm after covered stent placement for post-Whipple operation bleeding has not been reported in available literature. We consider the pseudoaneurysm formation is not only a consequence of visceral inflammation, but also related to the properties of a stent like rigidity in this case.