Acute upper gastrointestinal hemorrhage from a pseudoaneurysm of an unusual superior polar artery of the spleen

Abstract

Splenic artery (SA) aneurysm and pseudoaneurysm are rare pathologies and uncommon causes of massive upper gastrointestinal (GI) bleeding. They represent the third most common intra-abdominal aneurysms. Variations in the origin of SA are relatively common and asymptomatic. However, the presence of an accessory SA that is symptomatic is quite atypical. In this report, we describe the case of a 73-year-old female who presented with massive upper GI bleeding caused by a pseudoaneurysm of a superior polar artery with an unusual anatomic origin. The patient was successfully treated endovascularly with transarterial coil embolization. Early diagnosis and interventional management are crucial for patient's survival; hence, it must be kept in mind as possible etiology of life-threatening GI bleeding to reduce morbidity and mortality.

Acquired Gastric Dieulafoy-Like Lesion due to Aberrant Blood Supply Diverted From the Left Phrenic Artery to an Enlarged Splenule

“…It is important to distinguish DL from other arterial lesions that can appear similar endoscopically including hereditary hemorrhagic telangiectasia, vascular neoplasms, angiodysplasia, aneurysms, and pseudoaneurysms. 4 , 10 …”

“…It is important to distinguish DL from other arterial lesions that can appear similar endoscopically including hereditary hemorrhagic telangiectasia, vascular neoplasms, angiodysplasia, aneurysms, and pseudoaneurysms. 4,10 We present a case an acquired gastric Dieulafoy-like lesion 39 years postsplenectomy due to spleen trauma. The patient had an enlarged splenule with a hypertrophied blood supply diverted from the left phrenic artery.…”

Atypically Taut Superior Polar Splenic Artery Discovered in a Human Cadaver

“…The artery, therefore, traced an atypically straight and taut path towards the superior pole of the spleen. While a more fixed position may lead to a higher risk of arterial tearing, there have only been three reported cases of gastrointestinal bleeding attributed to polar splenic arteries [ 18 , 19 ]. Grippi and Yu recently discovered a pseudoaneurysm leading to gastrointestinal bleeding from a superior polar splenic artery in a 73-year-old female patient [ 19 ].…”

A rare case report of acute upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm

“…A literature search performed on the PubMed database revealed 11 reported cases of GI hemorrhage due to SAP rupture to date. 6,7,[9][10][11][12][13][14][15][16][17] In addition, because an SAP rupture is a life-threatening condition, a diagnosis should be promptly determined based on endoscopy or imaging modalities, especially CT. The fatal complications are independent of pseudoaneurysm size; therefore, treatment planning should occur immediately upon diagnosis.…”