Pseudoaneurysm of the splenic artery mimicking a solid lesion

  • Raffaele Pezzilli | raffaele.pezzilli@aosp.bo.it Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.
  • Monica Cevenini Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.
  • Cristina Mosconi Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.
  • Nico Pagano Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.
  • Matteo Renzulli Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.
  • Rita Golfieri Radiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, Bologna, Italy.

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.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

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
Published
2016-08-03
Info
Issue
Section
Case Reports
Keywords:
Abdominal mass, Pseudoaneurysm, Radiology, Endoscopic ultrasound
Statistics
  • Abstract views: 580

  • PDF: 328
How to Cite
Pezzilli, R., Cevenini, M., Mosconi, C., Pagano, N., Renzulli, M., & Golfieri, R. (2016). Pseudoaneurysm of the splenic artery mimicking a solid lesion. Emergency Care Journal, 12(2). https://doi.org/10.4081/ecj.2016.5880