Document Type
Poster
Version Deposited
Published Version
Publication Date
3-2025
Conference Name
2025 Camden Scholar's Forum
DOI
10.31986/issn.2689-0690_rdw.cmsru_fac_pub.1063
Abstract
Introduction: Splenic artery pseudoaneurysm (SAP) is a rare and fatal complication of pancreatitis which, in the presence of a pseudocyst, requires prompt intervention to prevent rupture and hemorrhagic shock.
Case Description: A 43-year-old female with a history of chronic alcohol use, hypertension, and acute on chronic pancreatitis complicated by a pseudocyst requiring cystogastrostomy, presented as a direct transfer with abdominal pain, nausea, and poor intake by mouth. Computed tomography of the abdomen and pelvis with intravenous contrast revealed an enlarged pancreas with multiple calcifications and mild peripancreatic fat stranding. The pancreatic duct was dilated up to 9 mm, with a hyperdense area in the pancreatic tail measuring approximately 2.3 cm x 1.5 cm x 1.5 cm, concerning for SAP. The patient underwent a right common femoral approach coil and liquid embolization. This is not the most common approach, but was required given the distal tortuosity of the splenic artery.
Discussion: Pseudoaneurysms from pancreatitis occur in 1.3% to 10% of cases, with a high mortality rate of 90% if left untreated. Hemorrhagic shock is the most common presentation, making timely identification and intervention crucial. Although only 157 cases of SAPs have been documented in the literature, pancreatitis, malignancy, trauma, hypertension and iatrogenic injury have been identified as risk factors. In this case, the patient’s chronic alcohol use and acute on chronic pancreatitis were key contributors to the formation of SAP. Chronic alcohol use causes direct toxicity to pancreatic cells, leading to inflammation, fibrosis, and the formation of pseudocysts. Alcohol-induced pancreatitis also releases pancreatic enzymes, which can weaken arterial walls. The patient’s hypertension further exacerbates the risk and likelihood of pseudoaneurysm formation and rupture by increasing vascular wall stress. Embolization techniques such as direct intra-arterial approaches are utilized to treat SAP. In this case, a percutaneous approach was utilized.
Recommended Citation
Pruthi, Anika; Clark, Abigail; McMackin, Katherine; Hastings, Laurel; and Hsu, Michael, "Management of a Splenic Artery Pseudoaneurysm Secondary to Pancreatitis" (2025). Cooper Medical School of Rowan University Departmental Research. 60.
https://rdw.rowan.edu/cmsru_facpub/60
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