Tannoury J, Honein K, Abboud B. Splenic artery aneurysm presenting as a submucosal gastric lesion: A case report. World J Gastrointest Endosc 2016; 8(14): 496-500 [PMID: 27499832 DOI: 10.4253/wjge.v8.i14.496]
Corresponding Author of This Article
Bassam Abboud, MD, Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Alfred Naccache Street, Beirut 16-6830, Lebanon. dbabboud@yahoo.fr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jul 25, 2016; 8(14): 496-500 Published online Jul 25, 2016. doi: 10.4253/wjge.v8.i14.496
Splenic artery aneurysm presenting as a submucosal gastric lesion: A case report
Jenny Tannoury, Khalil Honein, Bassam Abboud
Jenny Tannoury, Khalil Honein, Department of Gastroenterology and Hepatology, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut 16-6830, Lebanon
Bassam Abboud, Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut 16-6830, Lebanon
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Saint Joseph University.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bassam Abboud, MD, Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Alfred Naccache Street, Beirut 16-6830, Lebanon. dbabboud@yahoo.fr
Telephone: +961-1-15300 Fax: +961-1-615295
Received: March 18, 2016 Peer-review started: March 21, 2016 First decision: May 17, 2016 Revised: May 23, 2016 Accepted: June 14, 2016 Article in press: June 16, 2016 Published online: July 25, 2016 Processing time: 125 Days and 11.2 Hours
Abstract
We are reporting the rare case of splenic artery aneurysm of 4 cm of diameter presenting as a sub mucosal lesion on gastro-duodenal endoscopy. This aneurysm was treated by endovascular coil embolization and stent graft implantation. The procedure was uneventful. On day 1, the patient presented an acute severe epigastric pain and cardiovascular arrest. Abdominal computed tomography scan showed an active leak of the intravenous contrast dye in the peritoneum from the splenic aneurysm. We performed an emergent resection of the aneurysm, and peritoneal lavage. Postoperatively, hemorrhagic choc was refractory to large volumes replacement, and intravenous vaso-active drugs. On day 2, he presented massive hematochezia. We performed a total colectomy with splenectomy and cholecystectomy for ischemic colitis, with spleen and gallbladder infarction. Despite vaso-active drugs and aggressive treatment with Factor VIIa, the patient died after uncontrolled disseminated intravascular coagulation.
Core tip: Recently, a per-cutaneous endovascular embolization procedure has become the first-line treatment for splenic artery aneurysm. This rare presentation, in this case, as sub-mucosal gastric lesion and bleeding after embolization of the aneurysm showed the gravity of this entity when the diameter of aneurysm is > 2 cm. Although the risk of rupture is low, ruptured splenic artery aneurysm carry a high mortality rate.
