A GI Bleed That Needs Treatment aSAP(A): A Case of a Ruptured 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.

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Tuberculous pancreatitis complicated by ruptured splenic artery pseudoaneurysm

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2013.5212 ◽

2013 ◽

Vol 79 (3-4) ◽

Cited By ~ 5

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.

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Splenic artery pseudoaneurysm and resultant haematosuccus pancreaticus

BMJ Case Reports ◽

10.1136/bcr-2020-239485 ◽

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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