We are grateful for the comments from the authors in relation to our article which was recently published in Cirugía y Cirujanos, referring to the different forms of presentation and therapeutic options for pancreatic pseudoaneurysms.
Indeed, although in our case the form of presentation was hypovolaemic shock, with the peculiarity that it manifested as a high digestive haemorrhage, presentation in the form of varying intensity of abdominal pain is also possible, as the authors describe well in one of the cases of their series.
Whatever the form of presentation, imaging tests, essentially the angio-CT scan, provide a firm diagnosis.
Although our case was resolved using surgery due to the patient's instability, and the impossibility of performing arteriography in our hospital, the latter combined with embolisation is the therapeutic option of choice. Furthermore, as our colleagues mention, direct puncture techniques of the pseudoaneurysm via laparotomy or percutaneously, and the injection of embolising substances have been demonstrated to be equally effective. The latter being more indicated for patients for whom surgery poses a high risk, where cannulation or identification via arteriography of the vessel supplying the pseudoaneurysm have failed. In these cases, percutaneous injection of human thrombin, guided by ultrasound or computed axial tomography, has achieved excellent results.1
Please cite this article as: Herrera-Fernández FA, Palomeque-Jiménez A, Serrano-Puche F, Calzado-Baeza SF, Reyes-Moreno M. Respuesta a Carta l Editor: Pseudoaneurismas pancreáticos: formas de presentación y opciones terapéuticas. Cir Cir. 2015;83:455.