Acute deterioration of a woman following acute pancreatitis with pseudocysts

Background A 49-year-old white female with a history of acute pancreatitis that was complicated by pseudocysts presented with severe acute-onset abdominal pain of a few hours duration with associated vomiting. Physical examination showed a soft abdomen with mild diffuse tenderness and positive bowel sounds. Initial blood work revealed a drop in her hematocrit, and elevated but stable amylase and lipase levels. A CT scan of the abdomen revealed a splenic artery pseudoaneurysm with extravasation of contrast medium into an adjacent pseudocyst. Investigations Physical examination, blood analysis and a CT scan of the abdomen with contrast medium. Diagnosis Splenic artery pseudoaneurysm bleeding into an adjacent pseudocyst. Management Embolization of the splenic artery across the neck of the pseudoaneurysm.