PMC4712557_01
Abdominal CT scan and Endoscopic findings. a 6.0 mm x 10.4 mm saccular aneurysm was evident in the splenic artery (pancreatic segment of the splenic artery) at the body-tail junction of the pancreas (arrow). The aneurysm was out-pouching from the splenic artery perpendicularly down to the pancreas parenchyma. The aneurysm contacted the pancreatic duct, and the pancreatic duct proximal to the aneurysm was not dilated. However, the distal pancreatic duct was slightly dilated (up to 4.0 mm) (arrow head). The surrounding pancreas, especially distal to the aneurysm, was slightly lower in density after contrast enhancement. This finding suggests swelling. b On admission day 9, esophagogastroduodenoscopy showed active hemorrhage from the major papilla
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Fig1
The pancreatic duct proximal to the aneurysm was not dilated; however, the distal pancreatic duct was slightly dilated up to 4.0 mm (Fig. 1a). An emergency esophagogastroduodenoscopy (EGD) was performed and revealed fresh blood in the stomach and duodenum with active hemorrhage from the major papilla, a finding suggestive of hemosuccus pancreaticus (Fig. 1b).
Angiographic finding and endovascular treatment. a Angiography of the splenic artery revealed a 5-mm saccular aneurysm of the splenic artery (arrow). b The splenic artery aneurysm after implantation of a 28-mm Jostent. c On a contrast-enhanced abdominal angiography CT scan obtained 10 days after the procedure, the splenic artery aneurysm was completely excluded (Stent, arrow)
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Fig2
Angiography confirmed the splenic artery aneurysm (SAA) in the pancreatic segment (Fig. 2a). Arteriography performed immediately after the procedure revealed successful occlusion of the aneurysm with the stent-graft (Fig. 2b). On a contrast-enhanced abdominal angiography CT scan obtained 10 days after the procedure, the SAA was completely excluded, but the affected artery and spleen were preserved (Fig. 2c).