Pseudoaneurysm of the Splenic Artery Following Bariatric Surgery

Copin, Aurelie; Jenard, Samuël; Chasse, Emmanuel

doi:10.1007/s11695-020-05146-3

Cited by 3 publications

(5 citation statements)

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“…A few cases of pseudoaneurysms that likely developed as complications from bariatric surgery have been reported in the literature 8–13. A case of a true SAA found incidentally during a gastric banding procedure has also been reported 14.…”

Section: Discussionmentioning

confidence: 99%

Open splenic artery aneurysm repair in a patient with previous laparoscopic sleeve gastrectomy

et al. 2022

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We present the case of a female patient in her 40s who underwent a splenic artery aneurysm (SAA) repair following a previous laparoscopic sleeve gastrectomy (SG). We aim to discuss the management approach to SAAs and considerations in the setting of previous bariatric surgery.The patient consented to this case report. We include preoperative and postoperative radiological images and intraoperative images.While pseudoaneurysms following bariatric surgery have been reported, we present a case of a likely true SAA following SG. Our experience may assist others who come across similar cases in the future.

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Section: Discussionmentioning

confidence: 99%

Open splenic artery aneurysm repair in a patient with previous laparoscopic sleeve gastrectomy

et al. 2022

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“…При остром панкреатите ферменты протеолиза, секретируемые поджелудочной железой, запускают факторы локального воспаления, вследствие которого развивается окклюзия близлежащих вен, а также возникают эрозии стенки артерий, что, в свою очередь, приводит к образованию псевдоаневризм селезеночной, гастродуоденальной, верхней брыжеечной и других артерий [8]. Для диагностики ЛА специалисту многопрофильного стационара прежде всего необходимо опираться на данные УЗИ с ЦДК, магнитно-резонансную томографию, компьютерную томографию с внутривенным болюсным контрастированием [9,[11][12][13][14][15]. «Золотым стандартом» в диагностике является ангиография, с помощью которой можно оценить размеры псевдоаневризмы, ее локализацию, рассчитать возможные риски и определить объем оперативного вмешательства [12].…”

Section: Discussionunclassified

“…Для диагностики ЛА специалисту многопрофильного стационара прежде всего необходимо опираться на данные УЗИ с ЦДК, магнитно-резонансную томографию, компьютерную томографию с внутривенным болюсным контрастированием [9,[11][12][13][14][15]. «Золотым стандартом» в диагностике является ангиография, с помощью которой можно оценить размеры псевдоаневризмы, ее локализацию, рассчитать возможные риски и определить объем оперативного вмешательства [12]. Первым этапом лечения должно быть рентгенэндоваскулярное вмешательство, при его неэффективности прибегают к традиционным хирургическим методам лечения [9].…”

Section: Discussionunclassified

Splenic artery pseudoaneurysm complicated by haemorrhage into pancreatic pseudocyst: a clinical case

Durleshter

Макаренко

Бухтояров

et al. 2021

Kuban. nauсh. med. vestnik

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Background. Splenic artery pseudoaneurysm is a rare complication of acute and chronic pancreatitis caused by an arterial wall lesion with aggressive pancreatic enzymes and followed by arrosive bleeding into pseudocyst lumen and the formation of a dense fibrous capsule prone to growth.Clinical Case Description. Patient M., 61 yo, was emergently admitted to Territorial Clinical Hospital No. 2 with a preliminary diagnosis: Chronic pancreatitis, incomplete remission. Pancreatic pseudocyst. Condition after endoscopic papillosphincterotomy, pancreatic duct stenting. Gastrointestinal haemorrhage. The patient complained of moderate persistent belting upper abdominal and left subcostal pain, nausea, general weakness, black liquid stool over last five days. Pancreonecrosis in history. Pseudocyst formation in two months, endoscopic papillosphincterotomy and pancreatic stenting in hospital, the aforementioned complaints appeared past three months. Moderate anaemia (haemoglobin 73 g/L, erythrocyte count 2.8 x 1012), hyperamylasaemia (amylase 170 U/L), no other pathology in general and biochemic blood panels. The patient was rendered urgent oesophagogastroduodenoscopy for large duodenal papilla, with no evident bleeding detected. Abdominal CT angiography revealed a haemorrhagic mass connected with splenic artery lumen in the projection of pancreatic tail. The patient was transferred to an interventional radiology room for coil embolisation of splenic artery. The postoperative period was benign, and the patient discharged on day 3 after surgery for outpatient surgical patronage. Definite clinical diagnosis: Chronic pancreatitis, incomplete remission. Splenic artery pseudoaneurysm with haemorrhage into pancreatic pseudocyst. Condition after endoscopic papillosphincterotomy, pancreatic duct stenting.Conclusion. Splenic artery pseudoaneurysm with haemorrhage into pancreatic pseudocyst is reluctant to early diagnosis due to a lacking definite clinical picture and tractable only at an interdisciplinary institution disposing with a rich diagnostic toolkit and sufficiently qualified medical personnel. Endovascular treatment is overall most effective and enables a reliable aneurysm isolation from the splenic artery basin.

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“…The overall incidence of PSAs following abdominal and pelvic surgery is relatively low; however, the incidence of PSAs formation increases with the more invasive surgeries [18]. Vessel wall disruption may be related to a direct injury during abdominal procedure or surgery, various endoscopic treatments, or an indirect injury from post-operative perivascular inflammation or infection, resulting in the formation of PSA [19]. The process of clearing the lymph nodes around the artery with electrocautery and ultrasonic scalpel and removing vessel wall adventitia in addition to clamping of vessels may lead to vessel tear and subsequent contained vascular lesion development, such as PSAs [20,21] (Figure 2).…”

Section: Etiologymentioning

confidence: 99%

“…The sac packing technique consists in only sac embolization, maintaining the patency of the parent artery; however, since it is very difficult to obtain a complete sac embolization, this technique needs a careful follow-up due to the risk of recanalization being very high. The proximal embolization consists in embolization only of the splenic artery segment proximal to PSA; generally, this technique is used only in case where the vasoconstriction is very high, and it could not allow distal catheterization [18][19][20]. The embolization procedure demonstrates a 96% success rate with low complication rates and high survival rate [1].…”

Section: Dsa and Treatmentmentioning

confidence: 99%

Splenic Artery Pseudoaneurysms: The Role of ce-CT for Diagnosis and Treatment Planning

et al. 2022

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Splenic artery pseudoaneurysm (PSA) is a contained vascular wall lesion associated with a high mortality rate, generally related to pancreatitis, trauma, malignancy, iatrogenic injury, and segmental arterial mediolysis. Computed tomography angiography allows us to visualize the vascular anatomy, differentiate a PSA from an aneurysm, and provide adequate information for endovascular/surgical treatment. The present review reports on the main state-of-the-art splenic artery PSA diagnosis, differentiating between the pros and cons of the imaging methods and about the endovascular treatment.

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Pseudoaneurysm of the Splenic Artery Following Bariatric Surgery

Cited by 3 publications

References 10 publications

Open splenic artery aneurysm repair in a patient with previous laparoscopic sleeve gastrectomy

Open splenic artery aneurysm repair in a patient with previous laparoscopic sleeve gastrectomy

Splenic artery pseudoaneurysm complicated by haemorrhage into pancreatic pseudocyst: a clinical case

Splenic Artery Pseudoaneurysms: The Role of ce-CT for Diagnosis and Treatment Planning

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