DIAGNOSIS
Pancreatic pseudocyst with Pseudoaneurysm-
FINDINGS
•A well-defined oval cyst isseen abutting the pancreatic body and tail, suggestive of a pancreatic pseudocyst. The pancreatic duct is minimally prominent. Thecyst is seen anteriorly abutting the stomach wall with resultant diffuse oedematousthickening of the walls of the stomach.A few ill-defined hyperdensitiesare seen within the cyst, suggestive of chronic hemorrhages/ sludge
•Atiny nodular well-defined intensely enhancing lesion is seen along the cyst wall anteriorly on arterialphase representing peseudoaneurysm.
DISCUSSION
•Pancreatic pseudocysts are common sequelaeof acute or chronic pancreatitis and represent one of the most common cystic lesions of the pancreas.
•Pseudocystsappear as well-circumscribed, usually round or oval intra or peripancreatic fluid collections that are usually surrounded by a well-definedwall.Theymay or may not have communication with pancreatic duct.
•Complications associated with pancreatic pseudocysts are infection, rupture and hemorrhage. They can erode into adjacent vessels, the splenic artery most commonly, and produce a pseudoaneurysm. These pseudoaneurysms can rupture and result in intraperitoneal and gastrointestinal bleed.
•Pancreatic pseudoaneurysm is a rare complication with severe prognosis and hence early detection and management is mandatory.
•High resolution MDCT or MR angiography can depict the pseudoaneurysmas a well-delineated rounded structure originating from the donor artery.
