Pseudoaneurysm development after stenting for malignant biliary obstruction.

Reference A 78-year-old man with locally advanced adenocarcinoma of he pancreas presented to the emergency department with an acute istory of fresh rectal bleeding. He had signs of hypovolaemic shock nd his haemoglobin decreased from 9.3 to 6.9 g/dL over 12 h. He ad previously received chemotherapy and chemo-radiotherapy nd 4 months prior had undergone an endoscopic retrograde holangio-pancreatography (ERCP) and biliary stenting for jaunice. The patient had a computerised tomography (CT) angiogram hich demonstrated a blush of contrast adjacent to the covered etal biliary stent. This was arising from a pseudoaneurysm of the astroduodenal artery at the level of the head of pancreas tumour djacent to the metal stent, with radiological evidence of active xtravasation (Fig. 1).