Acute necrotizing pancreatitis complicated with severe duodenal ischemia: a rare complication of pancreaticoduodenal artery embolization

A 24-year-old patient presented with massive bleeding secondary to a duodenal ulcer. Vascular angiography identified hemorrhage originating from the superior and inferior pancreaticoduodenal arteries. Transcatheter arterial embolization (TAE) of the bilateral pancreaticoduodenal arteries were subsequently performed for hemostasis. Several hours after the interventional procedure, the patient developed acute necrotizing pancreatitis accompanied by severe duodenal ischemia. Although TAE is widely utilized for the treatment of upper gastrointestinal bleeding and avoids surgical trauma associated with conventional open operations, its potential procedural risks remain incompletely understood. This case report aims to raise clinical awareness of this rare but severe complication following pancreaticoduodenal arterial embolization (PAE).