Association of splenic artery pseudoaneurysm with recurrent pancreatitis

Muhammad Nadeem Yousaf; Fizah S Chaudhary; Amrat Ehsan; Marcos A Wolff; Charmian D Sittambalam

doi:10.1080/20009666.2020.1771070

Association of splenic artery pseudoaneurysm with recurrent pancreatitis

J Community Hosp Intern Med Perspect. 2020 Jun 14;10(3):290-293. doi: 10.1080/20009666.2020.1771070.

Authors

Muhammad Nadeem Yousaf^{1

2

3}, Fizah S Chaudhary^{1

2

3}, Amrat Ehsan^{1

2

3}, Marcos A Wolff⁴, Charmian D Sittambalam^{3

5}

Affiliations

¹ Department of Internal Medicine, Medstar Union Memorial Hospital, Baltimore, MD, USA.
² Department of Internal Medicine, MedStar Good Samaritan Hospital, Baltimore, MD, USA.
³ Department of Internal Medicine, Medstar Franklin Square Medical Center, Baltimore, MD, USA.
⁴ Department of Infectious Diseases, Medstar Franklin Square Medical Center, Baltimore, MD, USA.
⁵ Department of Internal Medicine, Georgetown University Medical Center, Washington, DC, USA.

Abstract

A pseudoaneurysm of the splenic artery (SAP) is a rare entity which is associated with pancreatitis in 52% of cases. In the presence of pancreatitis, the enzymatic damage to the wall of splenic artery results in pseudoaneurysm formation. The clinical presentation is variable and ranges from asymptomatic to hemodynamic instability. The diagnosis of SAP is challenging in the presence of peripancreatic fluid collection or pseudocyst, where CT abdomen can miss small pseudoaneurysms. Angiography is a useful modality to establish a definitive diagnosis. We present a 49-year-old male with a history of recurrent pancreatitis due to alcoholism who presented with acute abdominal pain and was found to have acute pancreatitis. Abdominal CT scan showed a peripancreatic fluid collection and hyperdense lesion at the splenic hilum, which was diagnosed as SAP on angiography. A transcatheter embolization was performed with complete resolution of symptoms thereafter.

Keywords: Splenic artery; angiography; pancreatic cyst; pancreatitis; pseudoaneurysm.

Publication types

Case Reports