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Endovascular treatment of acute gastrointestinal bleeding from a large splenic artery pseudoaneurysm: case report and literature review

Pseudoaneurysm of the splenic artery is a rare entity, with little more than 150 cases described in the literature. Pancreatitis is the most common etiology, followed by trauma. In contrast with true aneurysms, pseudoaneurysms are frequently symptomatic, with a 47% risk of rupture and 90% mortality...

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Detalles Bibliográficos
Autores principales: Prette, Paulo Roberto, Fagundes, Felipe Borges, Marchon, Livia Ramos Carvalho, Maciel, Rodrigo de Rezende Teixeira, Martins, Igor Miguel, Riguetti-Pinto, Cristina Ribeiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326128/
https://www.ncbi.nlm.nih.gov/pubmed/30643510
http://dx.doi.org/10.1590/1677-5449.005517
Descripción
Sumario:Pseudoaneurysm of the splenic artery is a rare entity, with little more than 150 cases described in the literature. Pancreatitis is the most common etiology, followed by trauma. In contrast with true aneurysms, pseudoaneurysms are frequently symptomatic, with a 47% risk of rupture and 90% mortality if left untreated. We describe the case of a 48-year-old female patient who suffered a gastrointestinal hemorrhage associated with acute-on-chronic pancreatitis. During workup, endoscopy revealed signs of recent bleeding and magnetic resonance angiography of the abdomen showed a large pseudoaneurysm of the splenic artery. The patient underwent endovascular treatment with microcoil embolization and no further bleeding episodes occurred. Endovascular treatment is now an effective option with low morbidity and mortality and success rates in the range of 79-100%, making it a viable technique for patients with active abdominal inflammation. We conducted a review of endovascular techniques and embolization agents used to treat this pathology.