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Visceral Artery Pseudoaneurysm Rupture after Pancreaticoduodenectomy

Although mortality after pancreaticoduodenectomy (PD) in high volume centers is less than 5%, morbidity is still as high as 30 50%. Hemorrhage from ruptured pseudoaneurysm is a rapidly progressing and potentially fatal complication after PD.Visceral pseudoaneurysm after pancreatic surgery is well known by surgeons. Postpancreatectomy hemorrhage is a life threatening entity, and must be managed urgently. Here we report two cases, late massive bleeding after pancreaticoduodenectomy. First case is a 69-year-old male with a ruptured dorsal pancreatic artery pseudoaneurysm which was successfully treated with endovascular arterial coil embolization. Second case is a 52-year-old male patient with a ruptured gastroduodenal artery pseudoaneurysm which was treated with laparotomy. Upper gastrointestinal bleeding in the late postoperative period following PD should alert the surgeon to the possibility of a ruptured celiac vessel pseudoaneurysm.