PMC5036825_01
CT images of perigastric splenosis pre- and postembolization of the perfusing network.. Notes: (A) Selected contrast enhanced axial CT images acquired before (A, C, and E) and after (B, D, and F) embolization of an enlarged branch of the left inferior phrenic artery artery (as depicted by the solid arrows in A, B, C, and D) perfusing a grouping of perigastric splenosis. (B) and (D) reveal near complete resolution of the tortuous component of the gastric branch traversing the wall of the gastric fundus. The dashed arrow in (C) and (D) reveals a corresponding marked reduction in size of the extramural component of the gastric branch leading to perigastric splenosis. The solid arrows in axial images E and F reveal the dominant nodule within the grouping of perigastric splenosis.. Abbreviation: CT, computed tomography.
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The patient continued to have melena stool and a subsequent CT angiogram was acquired revealing an extensive network of enlarged arteries within the wall of the gastric fundus that were supplying a grouping of splenosis along the posterior aspect of the gastric fundus (Figure 1). The dominant arterial supply was localized to a branch of the left inferior phrenic artery, which underwent successful transarterial coil embolization that was confirmed on a follow-up CT scan (Figures 1 and 2).
Selective angiogram and embolization of a gastric branch of the left phrenic artery perfusing the largest splenic nodule.. Notes: (A) Selective angiogram of a markedly enlarged gastric branch of the left phrenic artery perfusing the largest splenic nodule of a grouping of perigastric splenosis (arrow). The dashed line approximates the component of the artery traversing the wall of the gastric fundus. (B) Selective angiogram following successful embolization of the gastric branch with multiple coils (arrows). The dashed arrow identifies ascending branch of left inferior phrenic artery.
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The dominant arterial supply was localized to a branch of the left inferior phrenic artery, which underwent successful transarterial coil embolization that was confirmed on a follow-up CT scan (Figures 1 and 2).