title: Intra-abdominal hemorrhage due to rupture of a splenic vein aneurysm: a case report.
abstract: Splenic vein aneurysm (SVA) is extremely rare. Most patients with an SVA have portal hypertension. In this report we describe the first recorded case of intra-abdominal hemorrhage due to rupture of an SVA in a patient without evidence of portal hypertension. A 72-year-old man was admitted to our medical center in a state of shock, with complaints of acute abdominal pain and abdominal distention. Preoperatively, abdominal ultrasonography demonstrated an echo-free space in the abdomen, suggesting the presence of a fluid collection. In addition, computed tomography revealed an enhanced lesion with contrast material in the pancreatic tail. An emergency operation showed bleeding from the SVA near the pancreatic tail. Consequently, a distal pancreatectomy with splenectomy was performed. Histologically the lesion was diagnosed as an SVA surrounded by pancreatic tissue with chronic inflammatory changes. The patient's postoperative course was uneventful.
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo University School of Medicine, Tochigi, Japan. mshimoda@mednet.ucla.edu
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Shimoda
authors.forename: K
authors.initials: K
authors.lastname: Kubota
authors.forename: A
authors.initials: A
authors.lastname: Sakuma
authors.forename: T
authors.initials: T
authors.lastname: Hogami
authors.forename: H
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: N
authors.initials: N
authors.lastname: Tagaya
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications*; D002908:Chronic Disease; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D010180:Pancreatectomy; D010195:Pancreatitis / Q000150:complications; D013156:Splenectomy; D013162:Splenic Vein