Splenic Artery Pseudoaneurysm in Chronic Pancreatitis Causing Obstructive Jaundice: Endovascular Management

Ann Vasc Surg. 2021 Oct:76:599.e1-599.e5. doi: 10.1016/j.avsg.2020.09.019. Epub 2020 Sep 17.

Abstract

Background: Splenic artery pseudoaneurysm (SAP) around the pancreatic head causing obstructive jaundice is an extremely rare complication but can be life threatening once occurs. This case report is to raise awareness of this catastrophic complication and share our experience of successful endovascular management.

Methods: A 47-year-old male with a history of chronic pancreatitis clinically presented with epigastric pain and jaundice. Proximal SAP complicated with obstructive jaundice was confirmed by laboratory and imaging investigations. The SAP was successfully treated by transarterial coil embolization, and the jaundice subsequently improved.

Results: Abdominal contrast-enhanced computed tomography 11 months after embolization showed complete occlusion and reduction in the volume of the SAP as well as normal biliary tract.

Conclusions: SAP complicated with obstructive jaundice should be managed timeously and aggressively once diagnosed, given its potential adverse consequences. Transarterial embolization using the isolation technique may be a safe and effective strategy for treating this disease.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Embolization, Therapeutic*
  • Humans
  • Jaundice, Obstructive / diagnostic imaging
  • Jaundice, Obstructive / etiology*
  • Male
  • Middle Aged
  • Pancreatitis, Chronic / complications*
  • Pancreatitis, Chronic / diagnostic imaging
  • Splenic Artery* / diagnostic imaging
  • Treatment Outcome