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June 1989

Arterial Mycotic Aneurysm and RuptureA Potentially Fatal Complication of Pancreas Transplantation in Diabetes Mellitus

Author Affiliations

From the Departments of Surgery (Drs Tzakis, Gordon, Yokoyama, Makowka, and Starzl) and Medicine (Dr Carroll), University of Pittsburgh (Pa) Health Center; and Veterans Administration, Pittsburgh (Drs Tzakis, Carroll, Gordon, Yokoyama, Makowka, and Starzl).

Arch Surg. 1989;124(6):660-661. doi:10.1001/archsurg.1989.01410060022003

• 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.

(Arch Surg. 1989;124:660-661)