Rationale: Splenic artery pseudoaneurysm induced by benign gastric ulcer is extremely rare and can lead to a fatal clinical situation. To the best of our knowledge, there are only five cases in the literature review. Therefore, it can be a diagnostic challenge for radiologists and clinicians because of rare incidence.
Patient concerns: The patient visited our hospital due to melena and dizziness.
Diagnoses: The patient showed a huge ulcer and an exposed vessel in the posterior wall of the gastric high body during endoscopy. Angiography revealed a pseudoaneurysm of the splenic artery and contrast extravasation into the gastric lumen.
Interventions: We performed coil embolization of splenic artery and gastrectomy.
Outcomes: Postprocedural course was uneventful and led to patient discharge on day 8.
Lessons: We suggest that the splenic artery pseudoaneurysm should be considered differential diagnosis in the patients with acute upper gastrointestinal bleeding, and the presence of a splenic infarction may provide a diagnostic clue.