Top

Published in:

Open Access 01-12-2015 | Case report

Urgent endovascular ligature of a ruptured splenic artery pseudoaneurysm in a patient with acute pancreatitis: a case report

Authors: Anna Maria Ierardi, Mario Petrillo, Raffaella Capasso, Federico Fontana, Alessandro Bacuzzi, Ejona Duka, Domenico Laganà, Gianpaolo Carrafiello

Published in: Journal of Medical Case Reports | Issue 1/2015

Abstract

Introduction

We report on the successful endovascular treatment of a ruptured splenic artery pseudoaneurysm. Our patient had acute pancreatitis superimposed on chronic calcific pancreatitis and chronic renal impairment. Contrast-enhanced ultrasonography was used to assess post-embolization results.

Case presentation

Our patient was a 67-year-old white Caucasian man with recurrent pancreatitis. Computed tomography angiography showed a pancreatic pseudocyst with a ruptured pseudoaneurysm, which was successfully embolized using an endovascular percutaneous approach. At six months, persistent renal failure led to contrast-enhanced ultrasonography. This confirmed the absence of turbulent blood flow and extravasation of contrast medium in the pseudocyst.

Conclusion

Our experience with this case leads us to support the role of interventional radiology as a first-line treatment tool. Contrast-enhanced ultrasonography can be used to follow-up embolization procedures in patients with impaired renal function.

Tessier DJ, Stone WM, Fowl RJ, Abbas MA, Andrews JC, Bower TC, Gloviczki P: Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature.J Vasc Surg 2003,38(5):969–74. 10.1016/S0741-5214(03)00710-9CrossRefPubMed

Bhasin DK, Rana SS, Sharma V, Rao C, Gupta V, Gupta R, Kang M, Singh K: Non-surgical management of pancreatic pseudocysts associated with arterial pseudoaneurysm.Pancreatology 2013,13(3):250–3. 10.1016/j.pan.2013.02.011CrossRefPubMed

Janczak D, Fiktus A, Pawłowski L, Jaźwiec P, Chabowski M: Ruptured splenic artery aneurysm (Saa) as a complication of acute pancreatitis - case report.Pol Przegl Chir 2012,84(10):551–4.PubMed

De Rosa A, Gomez D, Pollock JG, Bungay P, De Nunzio M, Hall RI, Thurley P: The radiological management of pseudoaneurysms complicating pancreatitis.JOP 2012,13(6):660–6.PubMed

Hyare H, Desigan S, Brookes JA, Guiney MJ, Lees WR: Endovascular management of major arterial hemorrhage as a complication of inflammatory pancreatic disease.J Vasc Interv Radiol 2007,18(5):591–6. 10.1016/j.jvir.2007.02.035CrossRefPubMed

Stacul F, van der Molen AJ, Reimer P, Webb JA, Thomsen HS, Morcos SK, Almén T, Aspelin P, Bellin MF, Clement O, Heinz-Peer G, Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR): Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines.Eur Radiol 2011,21(12):2527–41. 10.1007/s00330-011-2225-0CrossRefPubMed

Ballinas-Oseguera GA, Martínez-Ordaz JL, Sinco-Nájera TG, Caballero-Luengas C, Arellano-Sotelo J, Blanco-Benavides R: Management of pseudoaneurysm of the splenic artery: report of two cases.Cir 2011,79(3):246–51. 268–273

Laganà D, Carrafiello G, Mangini M, Dionigi G, Caronno R, Castelli P, Fugazzola C: Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms.Eur J Radiol 2006,59(1):104–11. 10.1016/j.ejrad.2006.02.004CrossRefPubMed

Ten Bosch JA, Rouwet EV, Peters CT, Jansen L, Verhagen HJ, Prins MH, Teijink JA: Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair.J Vasc Interv Radiol 2010,21(5):638–43. 10.1016/j.jvir.2010.01.032CrossRefPubMed

10.

Catalano O, Cusati B, Nunziata A, Siani A: Active abdominal bleeding: contrast-enhanced sonography.Abdom Imaging 2006,31(1):9–16. 10.1007/s00261-005-0369-6CrossRefPubMed

11.

Carrafiello G, Laganà D, Recaldini C, Mangini M, Lumia D, Giorgianni A, Leonardi A, Fugazzola C: Combined percutaneous thrombin injection and endovascular treatment of gastroduodenal artery pseudoaneurysm (PAGD): case report.Emerg Radiol 2007,14(1):51–4. 10.1007/s10140-007-0574-4CrossRefPubMed

Title: Urgent endovascular ligature of a ruptured splenic artery pseudoaneurysm in a patient with acute pancreatitis: a case report
Authors: Anna Maria Ierardi
Mario Petrillo
Raffaella Capasso
Federico Fontana
Alessandro Bacuzzi
Ejona Duka
Domenico Laganà
Gianpaolo Carrafiello
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-9-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Urgent endovascular ligature of a ruptured splenic artery pseudoaneurysm in a patient with acute pancreatitis: a case report

Abstract

Introduction

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Subcutaneous emphysema and pneumomediastinum following cocaine inhalation: a case report

Blindness in a Sri Lankan woman with bilateral breast lumps: a case report

Neuromyelitis optica with linear enhancement of corpus callosum in brain magnetic resonance imaging with contrast: a case report

Parvovirus B19 infection presenting with severe erythroid aplastic crisis during pregnancy in a woman with autoimmune hemolytic anemia and alpha-thalassemia trait: a case report

Efficacy of inhibition of IL-1 in patients with rheumatoid arthritis and type 2 diabetes mellitus: two case reports and review of the literature

A homozygous AHI1 gene mutation (p.Thr304AsnfsX6) in a consanguineous Moroccan family with Joubert syndrome: a case report