Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review

Splenic artery aneurysms (SAA) are the third most common intra-abdominal aneurysm. Complications include invasion into surrounding structures often in association with preexisting pancreatic disease. We describe an 88-year-old female, with no history of pancreatic disease, referred with lower gastro...

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Main Authors: James O’Brien, Francesca Muscara, Aser Farghal, Irshad Shaikh
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2016/8461501
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author James O’Brien
Francesca Muscara
Aser Farghal
Irshad Shaikh
author_facet James O’Brien
Francesca Muscara
Aser Farghal
Irshad Shaikh
author_sort James O’Brien
collection DOAJ
description Splenic artery aneurysms (SAA) are the third most common intra-abdominal aneurysm. Complications include invasion into surrounding structures often in association with preexisting pancreatic disease. We describe an 88-year-old female, with no history of pancreatic disease, referred with lower gastrointestinal bleeding. CT angiography showed a splenic artery pseudoaneurysm with associated collection and fistula to the transverse colon at the level of the splenic flexure. The pseudoaneurysm was embolised endovascularly with metallic microcoils. Rectal bleeding ceased. The patient recovered well and follow-up angiography revealed no persistence of the splenic artery pseudoaneurysm. SAA rupture results in 29%–50% mortality. Experienced centres report success with the endovascular approach in haemodynamically unstable patients, as a bridge to surgery, and even on a background of pancreatic disease. This case highlights the importance of prompt CT angiography, if endoscopy fails to identify a cause of gastrointestinal bleeding. Endovascular embolisation provides a safe and effective alternative to surgery, where anatomical considerations and local expertise permit.
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institution Kabale University
issn 2090-6986
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publishDate 2016-01-01
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spelling doaj-art-231c22bfbb8c4885ab8e908ee44fdb312025-08-20T03:54:48ZengWileyCase Reports in Vascular Medicine2090-69862090-69942016-01-01201610.1155/2016/84615018461501Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature ReviewJames O’Brien0Francesca Muscara1Aser Farghal2Irshad Shaikh3Department of General Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UKDepartment of General Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UKDepartment of General Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UKDepartment of General Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UKSplenic artery aneurysms (SAA) are the third most common intra-abdominal aneurysm. Complications include invasion into surrounding structures often in association with preexisting pancreatic disease. We describe an 88-year-old female, with no history of pancreatic disease, referred with lower gastrointestinal bleeding. CT angiography showed a splenic artery pseudoaneurysm with associated collection and fistula to the transverse colon at the level of the splenic flexure. The pseudoaneurysm was embolised endovascularly with metallic microcoils. Rectal bleeding ceased. The patient recovered well and follow-up angiography revealed no persistence of the splenic artery pseudoaneurysm. SAA rupture results in 29%–50% mortality. Experienced centres report success with the endovascular approach in haemodynamically unstable patients, as a bridge to surgery, and even on a background of pancreatic disease. This case highlights the importance of prompt CT angiography, if endoscopy fails to identify a cause of gastrointestinal bleeding. Endovascular embolisation provides a safe and effective alternative to surgery, where anatomical considerations and local expertise permit.http://dx.doi.org/10.1155/2016/8461501
spellingShingle James O’Brien
Francesca Muscara
Aser Farghal
Irshad Shaikh
Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
Case Reports in Vascular Medicine
title Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
title_full Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
title_fullStr Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
title_full_unstemmed Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
title_short Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review
title_sort haematochezia from a splenic artery pseudoaneurysm communicating with transverse colon a case report and literature review
url http://dx.doi.org/10.1155/2016/8461501
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AT francescamuscara haematocheziafromasplenicarterypseudoaneurysmcommunicatingwithtransversecolonacasereportandliteraturereview
AT aserfarghal haematocheziafromasplenicarterypseudoaneurysmcommunicatingwithtransversecolonacasereportandliteraturereview
AT irshadshaikh haematocheziafromasplenicarterypseudoaneurysmcommunicatingwithtransversecolonacasereportandliteraturereview