Prette Paulo Roberto, Fagundes Felipe Borges, Marchon Livia Ramos Carvalho, Maciel Rodrigo de Rezende Teixeira, Martins Igor Miguel, Riguetti-Pinto Cristina Ribeiro
Universidade do Estado do Rio de Janeiro - UERJ, Hospital Universitário Pedro Ernesto - HUPE, Departamento de Cirurgia Vascular e Endovascular, Rio de Janeiro, RJ, Brasil.
Curso de Formação em Cirurgia Endovascular - Endocurso, Rio de Janeiro, RJ, Brasil.
J Vasc Bras. 2018 Jul-Sep;17(3):234-242. doi: 10.1590/1677-5449.005517.
Pseudoaneurysm of the splenic artery is a rare entity, with little more than 150 cases described in the literature. Pancreatitis is the most common etiology, followed by trauma. In contrast with true aneurysms, pseudoaneurysms are frequently symptomatic, with a 47% risk of rupture and 90% mortality if left untreated. We describe the case of a 48-year-old female patient who suffered a gastrointestinal hemorrhage associated with acute-on-chronic pancreatitis. During workup, endoscopy revealed signs of recent bleeding and magnetic resonance angiography of the abdomen showed a large pseudoaneurysm of the splenic artery. The patient underwent endovascular treatment with microcoil embolization and no further bleeding episodes occurred. Endovascular treatment is now an effective option with low morbidity and mortality and success rates in the range of 79-100%, making it a viable technique for patients with active abdominal inflammation. We conducted a review of endovascular techniques and embolization agents used to treat this pathology.
脾动脉假性动脉瘤是一种罕见疾病，文献报道的病例不足150例。胰腺炎是最常见的病因，其次是创伤。与真性动脉瘤不同，假性动脉瘤通常有症状，若不治疗，破裂风险为47%，死亡率为90%。我们报告一例48岁女性患者，她因慢性胰腺炎急性发作并发胃肠道出血。检查期间，内镜检查发现近期出血迹象，腹部磁共振血管造影显示脾动脉有一个大的假性动脉瘤。该患者接受了微线圈栓塞的血管内治疗，未再发生出血事件。血管内治疗目前是一种有效的选择，发病率和死亡率低，成功率在79%-100%之间，使其成为腹部有活动性炎症患者的可行技术。我们对用于治疗这种疾病的血管内技术和栓塞剂进行了综述。
