Giant splenic artery aneurysm rupture into the stomach that was successfully managed with emergency distal pancreatectomy

Chihiro Yoshikawa; Ichiro Yamato; Yasuyuki Nakata; Tadashi Nakagawa; Takashi Inoue; Mitsuhiro Nakatani; Daiki Nezu; Shunsuke Doi; Yasuhiro Kuroda; Kazuki Fujii; Shouhei Kishida; Midori Kamikubo; Saiho Ko

doi:10.1186/s40792-022-01498-3

Giant splenic artery aneurysm rupture into the stomach that was successfully managed with emergency distal pancreatectomy

Surg Case Rep. 2022 Aug 2;8(1):148. doi: 10.1186/s40792-022-01498-3.

Affiliations

¹ Department of Surgery, Nara Prefecture General Medical Center, 2-897-5 Shichijo-Nishimachi, Nara, 630-8581, Japan. pc.y.chi.476.hiro2180@gmail.com.
² Department of Surgery, Nara Prefecture General Medical Center, 2-897-5 Shichijo-Nishimachi, Nara, 630-8581, Japan.

Abstract

Background: Splenic artery aneurysms usually rupture into the free peritoneal space and rarely into the gastrointestinal tract. We report the case of a patient with a giant splenic artery aneurysm that ruptured in to the stomach with hemorrhagic shock and was successfully treated with emergency surgery.

Case presentation: A 59-year-old man presented to the emergency department with chest pain and syncope. Contrast-enhanced computed tomography showed splenic artery aneurysm with active contrast extravasation. He developed upper gastrointestinal (UGI) bleeding and hypovolemic shock. We diagnosed a splenic artery aneurysm ruptured in to the stomach, performed emergency distal splenopancreatectomy including the aneurysm and partial gastric resection, and could prevent patient death.

Conclusions: This report shows that splenic artery aneurysm can cause UGI bleeding. Thus, clinicians should be alert about this condition when managing patients with UGI bleeding and/or splenic artery aneurysm.

Keywords: Case report; Emergency surgery; Hemorrhagic shock; Splenic artery aneurysm; Upper gastrointestinal bleeding.