J Korean Assoc Pediatr Surg.  2000 Dec;6(2):143-148. 10.13029/jkaps.2000.6.2.143.

Arterial Embolization for the Ruptured Splenic Artery Pseudoaneurysm in a Child

Affiliations
  • 1Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.

Keyword

Pancreatitis; Pancreatic Pseudocyst; Pseudoaneurysm of Splenic Artery; Transcatheter Arterial Embolization

MeSH Terms

Aneurysm, False*
Angiography
Child*
Hemorrhage
Humans
Laparotomy
Male
Mortality
Pancreatic Pseudocyst
Pancreatitis
Pancreatitis, Chronic
Rupture
Splenic Artery*
Tomography, X-Ray Computed
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