Splenic Artery Pseudoaneurysm Causing Massive Hematemesis 10 Years After Necrotizing Pancreatitis

2020 ◽  
Vol 54 (5) ◽  
pp. 455-457
Author(s):  
Reuben Chen ◽  
Girish Pande ◽  
Mary Ann Johnson
Keyword(s):  
Computed Tomography ◽  
Splenic Artery ◽  
Necrotizing Pancreatitis ◽  
Hemodynamic Instability ◽  
Regional Hospital ◽  
Emergency Laparotomy ◽  
Artery Pseudoaneurysm ◽  
Tertiary Center ◽  
Massive Hematemesis ◽  
Splenic Artery Pseudoaneurysm

We report a case of a 54-year-old male presenting to a regional hospital with severe hematemesis and hemodynamic instability. His medical history was significant for a previous episode of alcoholic necrotizing pancreatitis and pseudocyst, requiring cystoenterostomy drainage and debridement 10 years prior. He underwent multiple gastroscopies and one emergency laparotomy which failed to definitively treat the bleeding. A splenic artery pseudoaneurysm was diagnosed with computed tomography angiography, adjacent to the previous cystoenterostomy site. The patient was transferred to a major tertiary center with access to interventional radiology and underwent successful embolization of the pseudoaneurysm.

scholarly journals Splenic Artery Pseudoaneurysm Masquerading as a Pancreatic Cyst—A Diagnostic Challenge

2015 ◽  
Vol 100 (6) ◽  
pp. 1069-1071 ◽  
Author(s):  
C. Chia ◽  
G. J. Pandya ◽  
A. Kamalesh ◽  
V. G. Shelat
Keyword(s):  
Splenic Artery ◽  
Unusual Case ◽  
Pancreatic Cyst ◽  
Incidental Finding ◽  
Hemodynamic Instability ◽  
Emergency Laparotomy ◽  
Diagnostic Challenge ◽  
Artery Pseudoaneurysm ◽  
Surgical Ligation ◽  
Splenic Artery Pseudoaneurysm

Splenic artery pseudoaneurysm is a rare entity. Clinical diagnosis is challenging because presentation is often varied. It can range from an incidental finding to hemodynamic collapse from sudden rupture and bleeding. The most common cause of this condition is pancreatitis. We report an unusual case of a young man not known to have pancreatitis who presented with hematemesis with normal esophagogastroduodenoscopy. Imaging modalities did not lead to a definitive diagnosis, and he underwent emergency laparotomy with surgical ligation of splenic artery pseudoaneurysm for hemodynamic instability, without a definitive preoperative diagnosis.

scholarly journals Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Peeyush Varshney ◽  
Bhupen Songra ◽  
Shivank Mathur ◽  
Sudarshan Gothwal ◽  
Puneet Malik ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Emergency Laparotomy ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Difficult Situation ◽  
Artery Pseudoaneurysm ◽  
Adjacent Structures ◽  
Massive Hematemesis ◽  
Splenic Vessels ◽  
Splenic Artery Pseudoaneurysm

Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation.Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure. FNA taken at the time of EUS was consistent with inflammatory pathology. Triple phase CT of the abdomen revealed a splenic artery pseudoaneurysm with multiple splenic infarcts. After resuscitation we planned an emergency laparotomy; splenic artery pseudoaneurysm densely adherent to adjacent structures and associated with distal pancreatic necrosis was found. We performed splenectomy with repair of the defect in the stomach wall and necrosectomy. Postoperative course was uneventful and patient was discharged on day 8.Conclusion. Pseudoaneurysm can be at times a very difficult situation to manage; options available are either catheter embolisation if patient is vitally stable, or otherwise, exploration.

scholarly journals A case of splenic artery pseudoaneurysm rupture presenting as rectal bleeding in a regional hospital

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Jonathon N Holt ◽  
Heinrich E Schwalb
Keyword(s):  
Rectal Bleeding ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Regional Hospital ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Artery Pseudoaneurysm ◽  
Previous Trauma ◽  
Splenic Artery Pseudoaneurysm

Abstract Splenic artery pseudoaneurysm is a rare phenomenon most associated with chronic pancreatitis or previous trauma. Complications can include erosion and rupture into local structures, a situation that carries a reported mortality of 10–40%. A 58-year-old male with chronic alcoholic pancreatitis and a known splenic artery pseudoaneurysm presented to the emergency department of a regional hospital with rectal bleeding and sepsis. Computed tomography revealed a peri-splenic mass communicating with the splenic flexure. The patient was taken for an emergency splenectomy and left hemicolectomy and was confirmed to have rupture of the splenic artery aneurysm into the large bowel. This case presented with comparable features reported in the literature and demonstrates that access to emergency specialist surgical services in a regional setting offers the capability to manage rare, life threatening surgical emergencies.

scholarly journals A rare case report of acute upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110619
Author(s):  
Nguyen Dinh Luan ◽  
Nguyen Minh Duc ◽  
Nguyen Hong Son ◽  
Tran Minh Hien ◽  
Le Anh Huy ◽  
...  
Keyword(s):  
Gastrointestinal Hemorrhage ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Hemodynamic Instability ◽  
Splenic Artery Aneurysm ◽  
Upper Gastrointestinal Hemorrhage ◽  
Artery Pseudoaneurysm ◽  
Rare Case Report ◽  
Upper Gastrointestinal ◽  
Splenic Artery Pseudoaneurysm

Splenic artery aneurysm and splenic artery pseudoaneurysm are rare vascular pathologies. The splenic artery represents the third most common site for intra-abdominal aneurysms. In contrast with true splenic artery aneurysm, splenic artery pseudoaneurysm is typically symptomatic, presenting with a range of symptoms, from abdominal pain to hemodynamic instability due to rupture. However, gastrointestinal hemorrhage is an uncommon complication of splenic artery pseudoaneurysm. We report a case of acute upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm rupture. The patient was successfully treated by endovascular intervention.

scholarly journals A case of splenic artery pseudoaneurysm rupture in a bulimic patient with gastric ulcer

2020 ◽  
Vol 14 (2) ◽  
pp. 100-101 ◽  
Author(s):  
Lucio Brugioni ◽  
Jolanda Petri ◽  
Silvia Speranza Cirino ◽  
Lucia Amidei ◽  
Serena Scarabottini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Bulimia Nervosa ◽  
Splenic Artery ◽  
Computed Tomography Scan ◽  
Artery Pseudoaneurysm ◽  
History Of ◽  
Splenic Artery Pseudoaneurysm ◽  
Tomography Scan

Splenic artery pseudoaneurysm is a rarely described condition and it is even more rarely considered as a complication of peptic disease. The most common etiologies are pancreatitis, both chronic and acute, and trauma. Diagnosis can be challenging, including ultrasonography, computed tomography scan and angiography, the latter being useful also for therapy (embolization). Given her history of bulimia nervosa and the stress related to hospitalization, our patient was particularly predisposed to peptic ulcer.

scholarly journals Tuberculous pancreatitis complicated by ruptured splenic artery pseudoaneurysm

2013 ◽  
Vol 79 (3-4) ◽  
Author(s):  
M. Irfan ◽  
F. Thiavalappil ◽  
J. Nagaraj ◽  
T.H. Brown ◽  
D. Roberts ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Splenic Artery ◽  
Artery Pseudoaneurysm ◽  
Pancreatic Tuberculosis ◽  
Pancreatic Lymph Nodes ◽  
Splenic Artery Pseudoaneurysm ◽  
Draining Lymph Nodes

Tuberculous pancreatitis complicated by ruptured splenic artery pseudoaneurysm. M. Irfan, F. Thiavalappil, J. Nagaraj, T.H. Brown, D. Roberts, L. Mcknight, N.K. Harrison. Tuberculosis involving the pancreas is rare. We report a patient with pancreatic tuberculosis complicated by haemorrhage from a splenic artery pseudoaneurysm. As far as we are aware, the development of a splenic artery pseudoaneurysm in association with a large caseating mass of tuberculous pancreatic lymph nodes has not been reported previously. We review the literature and discuss the varied presentations of tuberculosis involving the pancreas or the pancreatic bed and its draining lymph nodes.

Splenic artery pseudoaneurysm and resultant haematosuccus pancreaticus

2021 ◽  
Vol 14 (3) ◽  
pp. e239485
Author(s):  
Shwetambari Sonanis ◽  
Benjamin Layton ◽  
Oliver Nicholson ◽  
DA Subar
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Splenic Artery ◽  
Clinical Symptoms ◽  
Cross Sectional ◽  
Artery Pseudoaneurysm ◽  
Risk Of Rupture ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Splenic Artery Pseudoaneurysm

Splenic artery pseudoaneurysm (SAP) is a rare and dangerous diagnosis with a high risk of rupture and death. It is the most common cause of main pancreatic duct haematoma—haematosuccus pancreaticus (HP). Neither SAP nor HP have specific clinical features that allow diagnosis without cross-sectional imaging. Upper gastrointestinal haemorrhage and a history of pancreatitis should raise clinical suspicion but ultimately endoscopy and CT are required. We report a case of a 51-year-old man without clinical symptoms in whom cross-sectional imaging was undertaken for incidental severe acute anaemia. This demonstrated stigmata of chronic pancreatitis and the main pancreatic duct was distended with dense material in keeping with haematoma. The diagnosis of a SAP bleeding into the main pancreatic duct was made radiologically. A subsequent oesophago-gastro-duodenoscopy confirmed the diagnosis. The imaging appearances, pathophysiology and management are discussed.

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