Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma
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....
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Wiley
2014-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2014/501937 |
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| author | Peeyush Varshney Bhupen Songra Shivank Mathur Sudarshan Gothwal Puneet Malik Mahnedra Rathi Rajveer Arya |
| author_facet | Peeyush Varshney Bhupen Songra Shivank Mathur Sudarshan Gothwal Puneet Malik Mahnedra Rathi Rajveer Arya |
| author_sort | Peeyush Varshney |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-0a540664eb224700a89d2bdca503c9dc |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
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| series | Case Reports in Surgery |
| spelling | doaj-art-0a540664eb224700a89d2bdca503c9dc2025-02-03T01:22:18ZengWileyCase Reports in Surgery2090-69002090-69192014-01-01201410.1155/2014/501937501937Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic DilemmaPeeyush Varshney0Bhupen Songra1Shivank Mathur2Sudarshan Gothwal3Puneet Malik4Mahnedra Rathi5Rajveer Arya6General Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaGeneral Surgery, SMS Medical College, B-207 Janta Colony, Jaipur, Rajasthan 302004, IndiaIntroduction. 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.http://dx.doi.org/10.1155/2014/501937 |
| spellingShingle | Peeyush Varshney Bhupen Songra Shivank Mathur Sudarshan Gothwal Puneet Malik Mahnedra Rathi Rajveer Arya Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma Case Reports in Surgery |
| title | Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma |
| title_full | Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma |
| title_fullStr | Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma |
| title_full_unstemmed | Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma |
| title_short | Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma |
| title_sort | splenic artery pseudoaneurysm presenting as massive hematemesis a diagnostic dilemma |
| url | http://dx.doi.org/10.1155/2014/501937 |
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