We report the case of a 56-year-old woman with a presyncopal episode followed by melena. A sentinel clot sign in the pancreatic duct on precontrast computed tomography and the presence of a splenic artery aneurysm on postcontrast computed tomography strongly suggested a fistula between the aneurysm and the duct, as visualized by magnetic resonance imaging. The patient was treated successfully by complete embolization of the splenic artery aneurysm.
A case of mitochondrial encephalomyopathy (MELAS) with mental disorder is reported. The SPECT study using 123I-iodoamphetamine (IMP) and MRI study revealed abnormality in the left parieto-occipital areas without abnormality in the brain CT or brain scintigram. These findings suggest a localized dysfunction of the brain capillary endothelium in association with the cerebral involvement of mitochondrial encephalomyopathy.
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