Splenic infarction complicated by splenic artery occlusion after N-butyl-2-cyanoacrylate injection for gastric varices: case report

Introduction: Although endovascular therapy is becoming an alternative to open surgical repair of splenic artery aneurysms (SAAs), reports on the use of stent grafts for SAA repair are limited. We present our experience of endovascular therapy using a stent graft for the treatment of an SAA that had ruptured into the gastric lumen. We also reviewed 18 cases of stent graft repair for SAAs, including the present case. Case Report: A 43-year-old man was admitted due to hematemesis. Endoscopic examination and contrast-enhanced computed tomography (CT) revealed a dissecting SAA that had ruptured into the stomach. Two 10 × 100 mm Viabahn (W.L. Gore, Flagstaff, Arizona) stent grafts were used to exclude the aneurysm. No complications occurred during the procedure. Although postoperative CT showed complete exclusion of the aneurysm, endoscopic examination showed a discharge of purulent matter from the aneurysm. Therefore, surgical debridement and omental implantation were added to avoid stent graft infection. Follow-up CT obtained 1 year later showed the residual aneurysm almost disappeared without any evidence of infection. Literature Review: A literature search in the PubMed database returned 17 cases with sufficient data. Review of these cases, together with the present case, revealed a 100% technical success rate, 11% splenic infarction rate, 94% graft patency rate, and 0% reintervention rate. Conclusion: Endovascular repair of SAAs using stent grafts appears to be safe and effective. In terms of preserving the blood flow and avoiding splenic infarction, it may be superior to coil embolization. Even in a case with aneurysm infection, stent graft repair may be an acceptable method to minimize invasion of concomitant surgical intervention.

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Case Report: Acute Splenic Artery Thrombosis in a COVID 19, Postpartum Patient

Frontiers in Medicine ◽

10.3389/fmed.2021.698627 ◽

2021 ◽

Vol 8 ◽

Author(s):

Sebastian Daniel Trancǎ ◽

Oana Antal ◽

Anca Daniela Farcaş

Keyword(s):

Case Report ◽

Splenic Artery ◽

Post Partum ◽

Severe Form ◽

Splenic Infarction ◽

Thromboembolic Disease ◽

Hypercoagulable State ◽

Artery Thrombosis ◽

Therapeutic Anticoagulation ◽

Increased Risk

The incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease. Pregnancy, an already physiologically hypercoagulable state, associated to COVID 19, generates even more concern regarding the potentially increased risk of thrombotic events. The exact incidence of such complications is yet unknown, but there is data suggesting that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Since the outbreak of the COVID 19 pandemics, the most common described thrombotic events associated with SARS-COV2 infection have been venous thromboembolism and disseminated intravascular coagulation, while arterial thrombotic events are less commonly described. Splenic infarction is a rare disorder that can be secondary to a hypercoagulable state. There are only few cases of splenic infraction described, but none with splenic artery thrombosis, in a post-partum patient, on therapeutic anticoagulation regimen. We present the case of a 31-year-old Caucasian, 26 weeks pregnant woman, with no prior medical history, admitted to the hospital with a severe form of COVID 19 pneumonia and who, during the course of the disease, developed a massive splenic infarction with splenic artery thrombosis.

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Hypersplenism in a young girl: managed non-surgically

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173598 ◽

2017 ◽

Vol 5 (8) ◽

pp. 3742

Author(s):

Tanvi Batra ◽

Shipra Gulati ◽

Vijayashree S. Gokhale ◽

Arjun Lal Kakrani

Keyword(s):

Portal Hypertension ◽

Portal Vein ◽

Splenic Artery ◽

Gastric Varices ◽

Splenic Infarction ◽

Artery Embolization ◽

Splenic Artery Embolization ◽

Post Procedure ◽

Left Hypochondrium ◽

Grade Iii

A 16-years-old female, non-alcoholic, presented with pain in left hypochondrium and distention of abdomen. Her USG Abdomen, portal vein doppler and CT abdomen revealed chronic thrombosis of intrahepatic portion of portal vein with multiple collaterals and gross splenomegaly suggestive of portal hypertension. Trans jugular liver biopsy showed no regeneration or fibrosis of liver. Endoscopy showed grade III oesophageal and gastric varices. Splenic artery embolisation was done for hypersplenism. Post procedure CT abdomen revealed large areas of splenic infarction-sequelae of splenic artery embolization.

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