BACKGROUND: Splenic pseudoaneurysm is an uncommon disease. It occurs as a consequence of injury to the vascular wall, mostly inflammatory. The main symptom is gastrointestinal bleeding. The objective of this paper is to present the case of two patients with splenic pseudoaneurysm. CASE REPORTS: The first case we present is a 26-year-old male with a history of idiopatic pancreatitis, pancreatic abscess and colonic fistula 3 years prior. The second case is a 20-year-old male with a history of chronic kidney disease with peritoneal dialysis interrupted due to fungal (Candida albicans) peritonitis. Both patients presented with signs of lower gastrointestinal bleeding. Endoscopic examinations (upper endoscopy and colonoscopy) were inconclusive. Tomographic studies showed the lesion. Arteriography with embolization was performed and was satisfactory in one case and partially satisfactory in the other case. Surgery was done with proximal and distal ligation of the lesion with splenectomy. Postoperative evolution was satisfactory. During the follow-up for 6 and 12 months, neither patient has presented signs of recurrent bleeding. CONCLUSIONS: This is a very rare lesion usually presenting after a history of pancreatitis or abdominal trauma. This lesion must be ruled out in patients with obscure gastrointestinal bleeding. Arteriography with embolization is the best diagnostic and probably therapeutic procedure. Surgery is warranted for hemodynamically unstable patients, embolization failure or rebleeding.
BACKGROUND:Splenic pseudoaneurysm is an uncommon disease. It occurs as a consequence of injury to the vascular wall, mostly inflammatory. The main symptom is gastrointestinal bleeding. The objective of this paper is to present the case of two patients with splenic pseudoaneurysm. CASE REPORTS: The first case we present is a 26-year-old male with a history of idiopatic pancreatitis, pancreatic abscess and colonic fistula 3 years prior. The second case is a 20-year-old male with a history of chronic kidney disease with peritoneal dialysis interrupted due to fungal (Candida albicans) peritonitis. Both patients presented with signs of lower gastrointestinal bleeding. Endoscopic examinations (upper endoscopy and colonoscopy) were inconclusive. Tomographic studies showed the lesion. Arteriography with embolization was performed and was satisfactory in one case and partially satisfactory in the other case. Surgery was done with proximal and distal ligation of the lesion with splenectomy. Postoperative evolution was satisfactory. During the follow-up for 6 and 12 months, neither patient has presented signs of recurrent bleeding. CONCLUSIONS: This is a very rare lesion usually presenting after a history of pancreatitis or abdominal trauma. This lesion must be ruled out in patients with obscure gastrointestinal bleeding. Arteriography with embolization is the best diagnostic and probably therapeutic procedure. Surgery is warranted for hemodynamically unstable patients, embolization failure or rebleeding.
Authors: Anna Maria Ierardi; Mario Petrillo; Raffaella Capasso; Federico Fontana; Alessandro Bacuzzi; Ejona Duka; Domenico Laganà; Gianpaolo Carrafiello Journal: J Med Case Rep Date: 2015-01-09
Authors: Fabiana Seifert Santos; Karolaine Marcelina da Silva Sousa; Thiago Augusto Cadorin de Castro; Felipe Coelho; Rodrigo Gomes de Oliveira; Walter Jr Boim de Araujo; Lilian Cabral Pereira Dos Santos; Raquel Canzi Almada de Souza Journal: J Vasc Bras Date: 2018 Jan-Mar