Massive upper gastrointestinal bleeding from an accessory splenic artery mimicking isolated gastric varices

Abstract

Knowledge of anatomical variations of coeliac trunk and its branches is important (Folia Morphol 2013; 72, 4: 366-370)

Accessory Splenic Artery Causing Massive Gastrointestinal Bleed

“…3 The presentation of an upper GI bleed secondary to an accessory splenic artery is a rare circumstance, described in only 2 previous case reports. 4,5 Our report is the first to describe a massive upper GI bleed consequent of a submucosal accessory splenic artery arising from the left phrenic artery.…”

“…8 Previous case reports by Kervancioglu et al and Patel and Lowe have both described an accessory splenic artery arising from the left gastric artery and presenting as a gastric bleed. 4,5 Cadaveric dissections have also demonstrated the presence of accessory splenic arteries. Padmalath et al reported an accessory splenic artery in a cadaver, arising from the left gastroepiploic artery.…”

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

“…Rarely, it has origin from the abdominal aorta (8.1%) and from other sites such as the common hepatic artery, left gastric artery, or superior mesenteric artery [8] , [9] . In a few cases, the spleen is supplied by accessory SAs with cases reported originating from the left gastroepiploic artery, left gastric artery, or polar arteries arising primarily from the SA [4] , [10] , [11] .…”

“…Most of the SA aneurysms arise from the distal and middle third of the SA. Of the few rare cases of accessory SA variations, only 2 cases of an aneurysm from an accessory SA arising from the left gastric artery presenting as massive upper GI bleeding have been reported [4] , [11] . However, none has been documented arising from an SPA of the spleen.…”

Baffling Cause of Upper Gastrointestinal Bleeding!

“…Kervancioglu et al [2] described a similar presentation of massive GI bleeding where the accessory splenic artery was the culprit and it mimicked isolated gastric varices. Authors managed the patient with coil embolization of the artery.…”