Giant splenic artery aneurysm presenting with massive upper gastrointestinal bleeding: A case report and review of literature
| Autor: | Assunta Biscaglia, Beatrice Di Venere, Marina Rizzi, Emilia Tallarico, Riccardo Inchingolo, Maria Grazia Schievenin, Giancarlo Pacifico, Francesco Panzera |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
03 medical and health sciences Pseudoaneurysm Splenic artery aneurysm 0302 clinical medicine Aneurysm medicine.artery Case report medicine Computed tomography Upper gastrointestinal bleeding Past medical history medicine.diagnostic_test business.industry Esophagogastroduodenoscopy Gastroenterology Ileocolic artery Endoscopy General Medicine medicine.disease Curvatures of the stomach Surgery Hemorrhagic shock 030220 oncology & carcinogenesis Pancreatitis 030211 gastroenterology & hepatology business |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| DOI: | 10.3748/wjg.v26.i22.3110 |
| Popis: | Background Splenic artery aneurysm (SAA) and pseudoaneurysm are rare vessel's lesions. Pseudoaneurysm is often symptomatic and secondary to pancreatitis or trauma. True SAA is the most common aneurysm of visceral vessels. In contrast to pseudoaneurysm, SAA is usually asymptomatic until the rupture, with high mortality rate. The clinical onset of SSA's rupture is a massive life-threatening bleeding with hemodynamic instability, usually into the free peritoneal space and more rarely into the gastrointestinal tract. Case summary We describe the case of a 35-year-old male patient, with negative past medical history, who presented to the emergency department for massive upper gastrointestinal bleeding, severe anemia and hypotension. An esophagogastroduodenoscopy performed in emergency showed a gastric bulging in the greater curvature/posterior wall with a small erosion on its surface, with a visible vessel, but no active bleeding. Endoscopic injection therapy with cyanoacrylate glue was performed. Urgent contrast-enhanced computed tomography was carried out due to the clinical scenario and the unclear endoscopic aspect: The radiological examination showed a giant SAA which was adherent to posterior stomach wall, and some smaller aneurysms of the left gastric and ileocolic artery. Because of the high risk of a two-stage rupture of the giant SAA with dramatic outcome, the patient underwent immediate open surgery with aneurysmectomy, splenectomy and distal pancreatectomy with a good postoperative outcome. Conclusion The management of a ruptured giant SAA into the stomach can be successful with surgical approach. |
| Databáze: | OpenAIRE |
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