Pseudoaneurysm of the splenic artery mimicking a solid lesion

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Raffaele Pezzilli *
Monica Cevenini
Cristina Mosconi
Nico Pagano
Matteo Renzulli
Rita Golfieri
(*) Corresponding Author:
Raffaele Pezzilli | raffaele.pezzilli@aosp.bo.it

Abstract

A 64-year-old man presented to the hospital because of hematemesis; on admission, he had weakness and pale skin, tachycardia and hypotension. Laboratory tests revealed severe anemia (hemoglobin 7.8 g/dL); liver, renal and pancreatic function tests were normal. An upper digestive endoscopy revealed a gastric ulcer of the cardia, treated with metallic clips and adrenalin injection. The patient was treated with fluids and was transfused with three units of red blood cells. In the previous two months, due to the presence of bloating and diarrhea, associated with abdominal distension, a colon-computed tomography (CT) revealed a large retroperitoneal hypodense mass, 53x37 mm in size, without contrast enhancement localized between the body and the tail of the pancreas and the stomach, near the splenic artery and without signs of infiltration. To better define the mass, endoscopic ultrasound and biopsy were performed; however histopathology of multiple biopsies was not diagnostic, because of the presence of necrotic tissue and inflammatory cells. Since hematemesis recurred, the patient underwent a second upper digestive endoscopic examination, but no source of bleeding was found. Then a new contrast enhanced CT was performed that showed a size reduction of the mass, the presence of blood in the stomach and a small pseudoaneurysm of the splenic artery. Because of these findings an angiograpghic study was carried out; angiography confirmed a splenic artery pseudoaneurysm that was successfully embolized with metal microcoils.

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Author Biographies

Raffaele Pezzilli, Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna

Pancreas Unit

Monica Cevenini, Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna

Pancreas Unit

Cristina Mosconi, Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna

Radiology

Nico Pagano, Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna

Department of Digestive Disease

Matteo Renzulli, Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna

Radiology

Rita Golfieri, Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna

Radiology