PMC3971889_01
UGI endoscopy showing a picture of leiomyoma.
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Hb was 4.0 gm/dL, and other blood investigations were within normal limits. He already had an upper GI endoscopy (Figure 1) done outside stating large ulcer with undermined edge along lesser curvature at fundus with no active bleed.
EUS Doppler depicting a mass in wall of stomach.
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EUS Doppler done outside also (Figure 2) suggested a possibility of a heterogeneous mass lesion in fundus, likely leiomyoma.
CT scan of the abdomen showing a pancreatic tail mass.
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Patient also had a CT report which stated (Figure 3) a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure.
Triple phase CT finally giving the diagnosis of pseudoaneurysm.
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We finally got a triple phase CT of the abdomen (Figure 4) done at our institute which revealed a splenic artery pseudoaneurysm with multiple splenic infarcts.
Per operative photograph of the patient showing lesser sac with pseudoaneurysm and necrosed part of pancreas.
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On exploration splenic artery pseudoaneurysm densely adherent to adjacent structures and associated with distal pancreatic necrosis was found (Figure 5).