Clinical Practice and Cases in Emergency Medicine

Introduction: Post-pancreatectomy hemorrhage (PPH) is a deadly complication of pancreatectomy procedures. Rapid identification of these life-threatening complications is crucial to mitigating associated morbidity and mortality rates. Delayed PPH is managed similarly to aortoenteric fistulas with damage control resuscitation and emergent endovascular interventions such as embolization and stent placement.

Case Report: Here, we present the case of a delayed PPH presenting to the emergency department as a sentinel bleed secondary to a ruptured common hepatic artery pseudoaneurysm following a pancreatoduodenectomy.

Conclusion: With hepatobiliary procedures being performed with more frequency, emergency physicians must be aware of the deadly postoperative complications such as post-pancreatectomy hemorrhage, their presentations, and their treatments.