Pseudoaneurysm of the splenic artery mimicking a solid lesion

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...

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Main Authors: Raffaele Pezzilli, Monica Cevenini, Cristina Mosconi, Nico Pagano, Matteo Renzulli, Rita Golfieri
Format: Article
Language:English
Published: PAGEPress Publications 2016-08-01
Series:Emergency Care Journal
Subjects:
Online Access:http://www.pagepressjournals.org/index.php/ecj/article/view/5880
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author Raffaele Pezzilli
Monica Cevenini
Cristina Mosconi
Nico Pagano
Matteo Renzulli
Rita Golfieri
author_facet Raffaele Pezzilli
Monica Cevenini
Cristina Mosconi
Nico Pagano
Matteo Renzulli
Rita Golfieri
author_sort Raffaele Pezzilli
collection DOAJ
description 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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spelling doaj.art-04e2ac56746742ee8374b09dc997cd572022-12-22T03:01:55ZengPAGEPress PublicationsEmergency Care Journal1826-98262282-20542016-08-0112210.4081/ecj.2016.58804899Pseudoaneurysm of the splenic artery mimicking a solid lesionRaffaele Pezzilli0Monica Cevenini1Cristina Mosconi2Nico Pagano3Matteo Renzulli4Rita Golfieri5Pancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, BolognaPancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, BolognaRadiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, BolognaPancreas Unit, Department of Digestive System, Sant’Orsola-Malpighi University Hospital, BolognaRadiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, BolognaRadiology Unit, Department of Diagnostic and Preventive Medicine, Sant’Orsola-Malpighi University Hospital, BolognaA 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.http://www.pagepressjournals.org/index.php/ecj/article/view/5880Abdominal massPseudoaneurysmRadiologyEndoscopic ultrasound
spellingShingle Raffaele Pezzilli
Monica Cevenini
Cristina Mosconi
Nico Pagano
Matteo Renzulli
Rita Golfieri
Pseudoaneurysm of the splenic artery mimicking a solid lesion
Emergency Care Journal
Abdominal mass
Pseudoaneurysm
Radiology
Endoscopic ultrasound
title Pseudoaneurysm of the splenic artery mimicking a solid lesion
title_full Pseudoaneurysm of the splenic artery mimicking a solid lesion
title_fullStr Pseudoaneurysm of the splenic artery mimicking a solid lesion
title_full_unstemmed Pseudoaneurysm of the splenic artery mimicking a solid lesion
title_short Pseudoaneurysm of the splenic artery mimicking a solid lesion
title_sort pseudoaneurysm of the splenic artery mimicking a solid lesion
topic Abdominal mass
Pseudoaneurysm
Radiology
Endoscopic ultrasound
url http://www.pagepressjournals.org/index.php/ecj/article/view/5880
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