Yousaf Muhammad Nadeem, Chaudhary Fizah S, Ehsan Amrat, Wolff Marcos A, Sittambalam Charmian D
Department of Internal Medicine, Medstar Union Memorial Hospital, Baltimore, MD, USA.
Department of Internal Medicine, MedStar Good Samaritan Hospital, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2020 Jun 14;10(3):290-293. doi: 10.1080/20009666.2020.1771070.
A pseudoaneurysm of the splenic artery (SAP) is a rare entity which is associated with pancreatitis in 52% of cases. In the presence of pancreatitis, the enzymatic damage to the wall of splenic artery results in pseudoaneurysm formation. The clinical presentation is variable and ranges from asymptomatic to hemodynamic instability. The diagnosis of SAP is challenging in the presence of peripancreatic fluid collection or pseudocyst, where CT abdomen can miss small pseudoaneurysms. Angiography is a useful modality to establish a definitive diagnosis. We present a 49-year-old male with a history of recurrent pancreatitis due to alcoholism who presented with acute abdominal pain and was found to have acute pancreatitis. Abdominal CT scan showed a peripancreatic fluid collection and hyperdense lesion at the splenic hilum, which was diagnosed as SAP on angiography. A transcatheter embolization was performed with complete resolution of symptoms thereafter.
脾动脉假性动脉瘤（SAP）是一种罕见的疾病，52%的病例与胰腺炎相关。在胰腺炎存在的情况下，脾动脉壁的酶性损伤会导致假性动脉瘤形成。临床表现多样，从无症状到血流动力学不稳定不等。在胰周积液或假性囊肿存在的情况下，SAP的诊断具有挑战性，腹部CT可能会漏诊小的假性动脉瘤。血管造影是确立明确诊断的有用方法。我们报告一名49岁男性，有酗酒导致的复发性胰腺炎病史，因急性腹痛就诊，被发现患有急性胰腺炎。腹部CT扫描显示胰周积液和脾门处高密度病变，血管造影诊断为SAP。随后进行了经导管栓塞术，症状完全缓解。
