Fig. 2. Active bleeding after endoscopic ultrasound (EUS)-guided pancreatic drainage. (A) Abdominal computed tomography (CT) scan shows a peripancreatic fluid collection between the stomach and the spleen. (B) Brownish turbid fluid was drained through an EUS-guided, inserted cystogastrostomy stent. (C) Three days after the procedure, an abdominal CT scan showed high attenuation of the hematoma within the stomach but without an active bleeding focus. (D) Splenic arteriogram shows a pseudoaneurysm-like appearance (arrows) without its short gastric artery continuation into the spleen. (E) Selective angiogram with the microcatheter tip at the location of the pseudoaneurysm-like appearance, shows active bleeding into the pseudoaneurysm sac. N-butyl cyanoacrylate embolization was performed (not shown). (F) Post-embolization splenic arteriogram shows no further visualization of the pseudoaneurysm-like appearance. Clinically, the bleeding was thereby controlled.
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