Spontaneous regression of splenic artery pseudoaneurysm: a rare complication of acute pancreatitis

Abstract

Spontaneous pseudoaneurysm regression is a rare event. In particular, the spontaneous regression of a splenic artery pseudoaneurysm has, to our knowledge, been previously documented in only two case reports. Furthermore, the pathophysiological mechanism of this event remains unclear. However, it is fully known that this vascular complication is potentially life-threatening and presents a high mortality rate if untreated. We report the case of a 49-year-old man affected by acute pancreatitis. Computed tomography was performed, and showed a pseudoaneurysm of the splenic artery. This patient underwent endoscopic retrograde cholangiopancreatography to treat the pancreatitis, while the vascular complication was managed with a careful and conservative treatment. On day 6 of hospitalization, a second computed tomography scan was performed and revealed complete regression of the pseudoaneurysm. This case describes the diagnosis and management of splenic artery pseudoaneurysm following acute pancreatitis and its spontaneous regression.

Prevalence, treatment efficacy, and risk factors of vascular complications in acute pancreatitis: A case–control study

“…It affects 1.3%-10% of patients, and the splenic artery is the most common culprit artery (40%). 32,33 Consistent with these data, our study also showed that splenic artery was the most frequently implicated in AP with intraperitoneal bleeding.…”

Management of Visceral Mycotic Pseudoaneurysms

“…Pseudoaneurysms typically develop as a result of trauma, infection, or underlying inflammatory disease. [1][2][3][4][5] Mycotic pseudoaneurysms are caused by infection of the arterial wall leading to wall destruction and an unstable arterial outpouching. As opposed to true arterial aneurysms, pseudoaneurysms do not contain all three layers of the arterial wall, therefore, making them more prone for rupture.…”

Acute Gastric Hemorrhage due to Gastric Cancer Eroding Into a Splenic Artery Pseudoaneurysm: Two Dangerously Rare Etiologies of Upper Gastrointestinal Bleeding

“…Unlike splenic artery aneurysms (SAAs), splenic artery pseudoaneurysms (SAPs) are often symptomatic on presentation, with patients exhibiting abdominal pain and signs of UGIB including melena or hematochezia [ 4 , 5 ]. Despite their rarity, timely detection of ruptured SAPs is critical to the survival of patients as mortality can reach 90% in untreated cases [ 6 ]. We present the unusual hospital course of an 82-year-old male with advanced gastric cancer presenting with UGIB secondary to a visceral communication between his known gastric malignancy and a SAP.…”