Endovascular management of a rare inferior pancreaticoduodenal artery pseudoaneurysm secondary to chronic pancreatitis

A man in his 50s with chronic pancreatitis presented with epigastric pain and haematemesis. Imaging revealed pancreatic calcifications, multiple pseudocysts and a large pseudoaneurysm arising from the inferior pancreaticoduodenal artery. Despite initial endoscopy failing to identify the bleeding source, digital subtraction angiography confirmed the pseudoaneurysm, which was successfully treated with endovascular coil embolisation. The patient experienced transient melena-like stools postprocedure, but follow-up imaging ruled out active rebleeding. He was stabilised and discharged on a low-fat diet with resumed anticoagulation therapy. Pancreatic pseudoaneurysms are rare but life-threatening complications of chronic pancreatitis. Prompt diagnosis using imaging modalities like CT and angiography is critical. Endovascular coiling is an effective treatment, though postprocedure surveillance, including non-contrast CT, is essential to monitor for complications such as rebleeding.