Arterial mycotic aneurysm and rupture. A potentially fatal complication of pancreas transplantation in diabetes mellitus
A. G. Tzakis, P. B. Carroll, R. D. Gordon, I. Yokoyama, L. Makowka and T. E. Starzl
Department of Surgery, University of Pittsburgh, PA.
Mycotic aneurysm at the site of a Carrel patch arterial anastomosis
occurred in four patients who had undergone whole pancreas transplantation
2.5 to 14.5 months previously. In all patients, the graft had been removed,
leaving the Carrel patch on the iliac artery. The aneurysms ruptured into
the intestine or the extraperitoneal space. The ruptures were sudden and
life-threatening in three of four cases. This diagnosis must be suspected
in patients with a history of pancreas transplantation in the immediate or
distant past if they present with unexplained hypotension, cardiac arrest,
or gastrointestinal tract bleeding.
