Successful treatment of ruptured pseudo-splenic artery aneurysm with endovascular treatment in a hemodynamically stable patient: a case report.

BACKGROUND

Ruptured pseudo-splenic artery aneurysm is a rare but life-threatening condition, commonly related to pancreatitis or trauma. When spontaneous temporary hemostasis preserves hemodynamics, endovascular therapy may be feasible.

CASE PRESENTATION: A 48-year-old Japanese man presented with sudden epigastric pain. On arrival, he had peritoneal signs with preserved blood pressure; hemoglobin was 12.0 g/dL and lactate was 1.31 mmol/L. Contrast-enhanced computed tomography revealed a 40-mm partially thrombosed pseudo-splenic artery aneurysm in the distal splenic artery with hemoperitoneum and pancreatic calcifications consistent with chronic pancreatitis. Emergency endovascular embolization was performed using distal coil embolization followed by proximal injection of 33% N-butyl cyanoacrylate, achieving complete exclusion of the lesion. Blood loss was minimal and no transfusion was required. The patient was discharged on hospital day 22.

CONCLUSION

Endovascular embolization can be an effective, minimally invasive option for ruptured pseudo-splenic artery aneurysm when hemodynamics remain stable and treatment is promptly available.