Giant splenic artery aneurysm presenting with massive upper gastrointestinal bleeding:A case report and review of literature

作     者：Francesco Panzera Riccardo Inchingolo Marina Rizzi Assunta Biscaglia Maria Grazia Schievenin Emilia Tallarico Giancarlo Pacifico Beatrice Di Venere 

作者机构：Division of GastroenterologyDepartment of SurgeryMadonna delle Grazie HospitalMatera 75100Italy Division of Interventional RadiologyDepartment of RadiologyMadonna delle Grazie HospitalMatera 75100Italy Department of Intensive CareMadonna delle Grazie HospitalMatera 75100Italy Department of PathologyMadonna delle Grazie HospitalMatera 75100Italy Division of General SurgeryDepartment of SurgeryMadonna delle Grazie HospitalMatera 75100Italy 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第22期

页      面：3110-3117页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Splenic artery aneurysm Upper gastrointestinal bleeding Hemorrhagic shock Computed tomography Endoscopy Case report 

摘      要：BACKGROUND Splenic artery aneurysm(SAA)and pseudoaneurysm are rare vessel’s *** is often symptomatic and secondary to pancreatitis or *** SAA is the most common aneurysm of visceral *** contrast to pseudoaneurysm,SAA is usually asymptomatic until the rupture,with high mortality *** clinical onset of SSA’s rupture is a massive life-threatening bleeding with hemodynamic instability,usually into the free peritoneal space and more rarely into the gastrointestinal *** SUMMARY We describe the case of a 35-year-old male patient,with negative past medical history,who presented to the emergency department for massive upper gastrointestinal bleeding,severe anemia and *** esophagogastroduodenoscopy performed in emergency showed a gastric bulging in the greater curvature/posterior wall with a small erosion on its surface,with a visible vessel,but no active *** injection therapy with cyanoacrylate glue was *** contrast-enhanced computed tomography was carried out due to the clinical scenario and the unclear endoscopic aspect:The radiological examination showed a giant SAA which was adherent to posterior stomach wall,and some smaller aneurysms of the left gastric and ileocolic *** of the high risk of a two-stage rupture of the giant SAA with dramatic outcome,the patient underwent immediate open surgery with aneurysmectomy,splenectomy and distal pancreatectomy with a good postoperative *** The management of a ruptured giant SAA into the stomach can be successful with surgical approach.