Matsuda Y, Sakamoto K, Nishino E, Kataoka N, Yamaguchi T, Tomita M, Kazi A, Shinozaki M, Makimoto S. Pancreatectomy and splenectomy for a splenic aneurysm associated with segmental arterial mediolysis. World J Gastrointest Surg 2015; 7(5): 78-81 [PMID: 26015853 DOI: 10.4240/wjgs.v7.i5.78]
Corresponding Author of This Article
Yasuhiro Matsuda, MD, Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-chou, Kishiwada City, Osaka 596-8522, Japan. my-salsa@air.ocn.ne.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
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Matsuda Y, Sakamoto K, Nishino E, Kataoka N, Yamaguchi T, Tomita M, Kazi A, Shinozaki M, Makimoto S. Pancreatectomy and splenectomy for a splenic aneurysm associated with segmental arterial mediolysis. World J Gastrointest Surg 2015; 7(5): 78-81 [PMID: 26015853 DOI: 10.4240/wjgs.v7.i5.78]
Yasuhiro Matsuda, Kazuki Sakamoto, Naoki Kataoka, Tomoyuki Yamaguchi, Masafumi Tomita, Shinichiro Makimoto, Department of Surgery, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
Eisei Nishino, Department of Pathology, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
Arito Kazi, Masahiro Shinozaki, Department of Emergency and Critical Care Medical Center, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
Author contributions: Matsuda Y, Sakamoto K and Nishino E designed the report and wrote the paper; Kataoka N, Yamaguchi T, Tomita M, Kazi A, Shinozaki M and Makimoto S provided treatment.
Supported by The Department of Surgery, Kishiwada Tokushukai Hospital, Osaka, Japan.
Ethics approval: The study was reviewed and approved by the Institutional Review Board of Kishiwada Tokushukai Hospital for ethical issues.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: We certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Correspondence to: Yasuhiro Matsuda, MD, Department of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-chou, Kishiwada City, Osaka 596-8522, Japan. my-salsa@air.ocn.ne.jp
Telephone: +81-72-4459915 Fax: +81-72-4459791
Received: September 2, 2014 Peer-review started: September 4, 2014 First decision: February 7, 2015 Revised: February 23, 2015 Accepted: March 16, 2015 Article in press: March 18, 2015 Published online: May 27, 2015 Processing time: 258 Days and 0.2 Hours
Abstract
Segmental arterial mediolysis (SAM) is characterized by intra-abdominal, retroperitoneal bleeding or bowel ischemia, and the etiology is unknown. A 44-year-old man complaining of abdominal pain was admitted to our hospital. He had been admitted for a left renal infarction three days earlier and had a past medical history of cerebral aneurysm with spontaneous remission. The ruptured site of the splenic arterial aneurysm was clear via a celiac angiography, and we treated it using trans-arterial embolization. Unfortunately, the aneurysm reruptured after two weeks, and we successfully treated it with distal pancreatomy and splenectomy. We recommended a close follow-up and prompt radiological or surgical intervention because SAM can enlarge rapidly and rupture.
Core tip: Segmental arterial mediolysis (SAM) related to intra-abdominal, retroperitoneal bleeding or bowel ischemia has a mortality approaching 25%-50%. We treated the splenic artery aneurismal re-rupture associated with SAM after trans-catheter arterial embolization with a distal pancreatomy and splenectomy. We recommend close follow-ups and prompt radiological or surgical intervention because SAM can increase rapidly and rupture.
