Pseudo Aneurysm of the Splenic Artery Fistulized in the Stomach Revealed By Upper Digestive Hemorrhage

Liver abscesses secondary to bilio-enteric fistulas are rare and therefore unknown to the attending physician. In this report, we present a bilio-enteric communication, between the gallbladder; which was macro lithiasic; and the stomach revealed by an upper digestive hemorrhage in a septic context in a 34 year old man. A pyogenic bacterial liver abscess developed because of the fistula without biliary obstruction. The patient was treated surgically with disconnection of the fistula and drainage of the abscess. The liver abscess is probably due to the contamination of the bile by the cholecysto-gastric fistula. The germ isolated was a citrobacter freundii which is rarely involved in liver abscesses.

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Endoscopic ultrasound-guided coil and glue for treatment of splenic artery pseudo-aneurysm: new kid on the block!

Endoscopy International Open ◽

10.1055/a-0608-4402 ◽

2018 ◽

Vol 06 (07) ◽

pp. E821-E825

Author(s):

Praveer Rai ◽

Harish KC ◽

Amit Goel ◽

Rakesh Aggarwal ◽

Malay Sharma

Keyword(s):

Endoscopic Ultrasound ◽

Splenic Artery ◽

Angiographic Embolization ◽

Ultrasound Guided ◽

Artery Pseudoaneurysm ◽

Pseudo Aneurysm ◽

Safe Technique ◽

A New Technique ◽

Glue Injection ◽

Splenic Artery Pseudoaneurysm

Abstract Background and study aims Pseudoaneurysm most commonly involves the splenic artery and is conventionally treated with angioembolization or surgery. Herein we describe six patients with splenic artery pseudoaneurysm who were treated using a new technique of endoscopic ultrasound (EUS)-guided glue and coil injection. Patients and methods Six patients (median age 36.7, range: 19 – 60, M: F = 5:1) with splenic artery pseudoaneurysm who had failed angiographic embolization underwent EUS-guided transgastric injection of coil and glue injection between July 2016 and September 2017. Results The diameter of the splenic artery pseudoaneurysms varied from 2.5 cm to 6.5 cm. The size (8, 14 and 16 mm) and number (1 to 5) of coils and amount of glue (1 – 2 mL) injected all were greater in larger aneurysm. All six patients had complete occlusion of the pseudoaneurysm as determined by using computed tomography at 4 weeks and EUS at 12 weeks. No complication was encountered. Conclusion EUS-guided coil and glue injection for obliteration of splenic artery pseudoaneurysm is a feasible, highly effective and safe technique.

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Risk factors for upper digestive hemorrhage in liver cirrhosis

Journal of Hepatology ◽

10.1016/0168-8278(89)90431-5 ◽

1989 ◽

Vol 9 ◽

pp. S128

Author(s):

L. Buligescu ◽

M. Voiculescu

Keyword(s):

Risk Factors ◽

Liver Cirrhosis ◽

Digestive Hemorrhage ◽

Upper Digestive Hemorrhage

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Endovascular embolization of spontaneous rupture of isolated splenic artery dissection associated with hemosuccus pancreaticus: a case report

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02148-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jianjun Jiang ◽

Yang Liu ◽

Xiangjiu Ding

Keyword(s):

Coil Embolization ◽

Splenic Artery ◽

Computed Tomographic Angiography ◽

Endovascular Embolization ◽

Artery Dissection ◽

Hemosuccus Pancreaticus ◽

Computed Tomographic ◽

Digestive Hemorrhage ◽

Life Threatening ◽

Endovascular Coil Embolization

Abstract Background Isolated splenic artery dissection (SAD) is extremely rare, life-threatening, and particularly difficult to diagnose. Moreover, SAD presenting as digestive hemorrhage has not been reported. Case presentation A 44-year-old man presented with recurrent life-threatening hematochezia. Magnetic resonance and computed tomographic angiography showed isolated SAD with an intrapancreatic hematoma. Selective angiography confirmed the diagnosis of rupture of SAD. Hemosuccus pancreaticus was considered the potential mechanism of digestive hemorrhage. It was successfully managed by endovascular coil embolization. Conclusions Isolated SAD is especially rare but fatal. Rupture of SAD should be considered in the differential diagnosis as a rare cause of digestive hemorrhage. Endovascular coil embolization is effective in treating ruptured SAD.

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