“Post pancreatectomy hemorrhage (PPH) is a rare but fatal complication with reported mortality rates of 16%-50%. It is associated with significant morbidity and mortality, especially when repeat laparotomy is required to control bleeding. Among the causes of PPH, intraabdominal pseudoaneurysm is directly associated with prolonged hospital stay and death due to sudden hemorrhage. An aneurysm is a localized dilatation of the artery and can either be true aneurysm (involves all the 3 arterial layers) or pseudoaneurysm (lack a complete arterial wall or surrounded by soft tissue). An arterial leak is an extravasation or a persistent blood flow following arterial anastomosis or arterial repair into the aneurysm sac. The cause of post-PD pseudoaneurysms is described to be multifactorial. However, it is well known that pancreatic fistula is mostly associated with the development of pseudoaneurysm. Other factors predisposed for its development include iatrogenic trauma of vessel walls during lymphadenectomy, biliary fistula, mechanical irritations by
drainage tubes, and intra-abdominal infections that destroy the vessel wall.”