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Delayed massive hemorrhage following pancreaticoduodenectomy is a potentially fatal condition. These patients are often not surgical candidates, and endovascular therapy is the primary option of treatment, usually trans-arterial embolization. However, the bleeding vessel can occasionally be treated with a stent graft rather than embolization. This decreases the risk of hepatic necrosis by preserving hepatic arterial blood flow, particularly in patients with compromised portal veins. The authors present a brief case report of delayed pseudoaneurysm rupture from a replaced proper hepatic artery after pancreaticoduodenectomy with resultant portal vein occlusion, caused by hematoma mass effect. The hepatic artery was treated with a coronary stent. During the same session, trans-splenic portal vein stenting was done. Abstract

Hepatic Artery Pseudoaneurysm Rupture with Acute Portal Vein Occlusion Treated with Coronary Stent Graft and Trans-splenic Portal Vein Stenting