2014, Number 5
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Cir Cir 2014; 82 (5)
Rupture of splenic artery pseudoaneurysm: an unusual cause of upper gastrointetinal bleeding
Herrera-Fernández FA, Palomeque-Jiménez A, Serrano-Puche F, Calzado-Baeza SF, Reyes-Moreno M
Language: Spanish
References: 15
Page: 551-555
PDF size: 417.68 Kb.
ABSTRACT
Background: Bleeding from a pancreatic pseudocyst is a severe
complication after pancreatitis that can lead to a massive gastrointestinal
blood loss. Pseudocyst rupture into the stomach is an unusual
complication.
Clinical case: We report the case of a 34-year-old woman with a history
of alcoholism and a pancreatic pseudocyst. One year after follow-up
of her pseudocyst, she arrived at the emergency room with an episode
of upper gastrointestinal bleeding. An upper digestive endoscopy
showed active bleeding in the subcardial fundus, which could not
be endoscopically controlled. Abdominal angio-CT confirmed the
diagnosis of a splenic artery pseudoaneurysm in close contact with
the back wall of the stomach, as well as a likely fistulization of it. The
patient was urgently operated and a distal splenopancreatectomy and
fistulorrhaphy was performed.
Conclusion: The rupture of a splenic artery pseudoaneurysm may rarely
present as upper gastrointestinal bleeding. This may be lethal if not
urgently treated.
REFERENCES
Argibay Filgueira AB, Maure Noia B, Lamas Domínguez P, Martínez-Vázquez C. Hematoma retroperitoneal con neuropatía del femoral, ¿actitud conservadora o quirúrgica? An Med Interna 2006;23(4):197-198.
Kim JH, Kim JS, Kim CD, Lee HS, Cho YJ, Lee JS, et al. Clinical Features of Pseudoaneurysms Complicating Pancreatitis: Single Center Experience and Review of Korean Literature. Korean J Gastroenterol 2007;50(2):108-115.
Hsu JT, Yeh CN, Hung CF, Chen HM, Hwang TL, Jan YY, et al. Management and outcome of bleeding pseudoaneurysm associated with chronic Pancreatitis. BMC Gastroenterology 2006;6(3):1-7.
Urakami A, Tsunoda T, Kubozoe T, Takeo T, Yamashita K, Imai H. Rupture of a bledding pancreatic pseudocyst into the stomach. J Hepatobiliary Pancreat Surg 2002;9(3):383-385.
Araki KI, Shimura T, Watanabe A, Kobayasy T, Suzuki H, Suehiro T, et al. H. Gastric Bleeding from a Penetrating Pancreatic Pseudocyst with Pseudoaneurysm of Splenic Artery. Hepato-gastroenterology 2009;56(94-95):1411- 1413.
Flati G, Negro P, Porowska B, Flati D, Salvatori F, Saputelli A, et al. Massive pseudocysto-jejunal hemorrhage caused by rupture of pseudoaneurysm of the splenic artery. Rev Esp Enferm Dig 1994;86(6):918-921.
Morales Ruiz J, Gonzalez Castillo S, Viñolo Ubina C, Heredia Carrasco C, Del Hierro Ruiz López M. Pseudoaneurisma esplénico fistulizado a yeyuno secundario a pancreaititis aguda grave. Rev Esp Enferm Dig 2010;102(1):68-70.
Rosales Zabal JM, Navarro Jarabo JM, Rivera Irigoin R, Perez Aisa A, Marcos Herrero M, Sanchez Cantos AM. Rupture of a splenic pseudoaneurysm in the colon as an unusual cause of rectal bleeding. Colorectal Dis 2012;14(7):e425-e426.
Badea R, Seicean A, Procopet B, Dina L, Osian G. Pseudoaneurysm of Splenic Artery Ruptured in Pancreatic Pseudocysat and Complicated by Wirsungorraghia: The Role of the Ultrasound Techniuques and Contrast Substances. Ultraschall Med 2011;32(2):205-207.
Sethi H, Peddu P, Prachalias A, Kane P, Karani J, Rela M, et al. Selective embolization for bleeding visceral artery psudoaneurysms in patients with pancreatitis. Hepatobiliary Pancreat Dis Int 2010;9(6):634-638.
Durai R, Thomas D, El Gaddal A, Siddiqui M. Role of computed tomography in upper gastrointestinal bleeding. Br J Hosp Med (Lond) 2011;72(5):293.
Balderi A, Antonietti A, Ferro L, Peano E, Pedrazzini F, Fonio P, et al. Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol Med 2012;117(5):815-830.
Xin J, Xiao-Ping L, Wei G, Jiang X, Hong-Peng Z, Xiao- Hui M, et al. The endovascular management of splenic artery aneurysms and pseudoaneurysms. Vascular 2011;19(5):257-261.
Marone EM, Mascia D, Kahlberg A, Brioschi C, Tshomba Y, Chiesa R. Is Open Repair Still the Gold Standard in Visceral Artery Aneurisma Management? Ann Vasc Surg 2011;25(7):936-946.
Azabache Puente W, López Carranza M, Azabache Díaz J, Angulo Revilla I, Salazar Tantaleán A. Pseudoaneurisma Pancreático: tratamiento quirúrgico. Rev Gastroenterol 2008;28(1):60-64.