Ruptured Left Gastric Artery Pseudoaneurysm due to Acute-on-chronic Pancreatitis: A Case Report with Literature Review

Visceral artery pseudoaneurysms (PA) are a rare but potentially fatal complication associated with pancreatitis. Among these, PA of the left gastric artery (LGA) are extremely rare. We describe a case of a 43-year-old male who presented with severe epigastric pain, hematemesis, and hypovolemic shock. He was a chronic alcoholic and a known case of recurrent pancreatitis. Resuscitation was initiated, and laboratory findings revealed severe anemia and elevated pancreatic enzymes. An urgent contrast-enhanced computed tomography scan identified acute-on-chronic pancreatitis with pseudocysts and a bleeding PA originating from the gastroduodenal arcade. Emergency celiac angiography confirmed a LGA PA with active extravasation. Successful super-selective glue embolization was performed, resulting in immediate cessation of bleeding. The patient stabilized hemodynamically had an uneventful recovery. This case highlights the life-threatening nature of visceral artery PAs as a complication of pancreatitis and emphasizes the critical role of timely imaging and endovascular intervention in achieving a successful outcome.