Posttraumatic splenic artery aneurysm presenting as occult gastrointestinal bleeding.
A 53-year-old man presented with a 19-month history of gastrointestinal bleeding. Repeated endoscopic investigation of the upper and lower intestine showed no source of bleeding. When the patient collapsed due to massive gastrointestinal hemorrhage he was referred to our center. Gastroscopy showed a large, bulging tumor protruding from the posterior gastric wall. The consistency of this tumor was soft and the overlying mucosa appeared smooth and intact. Endoscopic ultrasound and contrast-enhanced computerized tomography scan identified a partly thrombosized splenic artery aneurysm (SAA). Arteriography of the celiac trunk confirmed the SAA diagnosis; the SAA was subsequently occluded by coils. So far, four months after discharge, the patient is in excellent health and no further episode of gastrointestinal bleeding has occurred. SAA is a very rare cause of upper gastrointestinal bleeding, but it must be considered when no other common bleeding source can be detected.
Koch
Robert
R
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria. robert.koch@uibk.ac.at
Graziadei
Ivo
I
Zoller
Heinz
H
Schwaighofer
Hubert
H
Jaschke
Werner
W
Vogel
Wolfgang
W
D000063:Accidents, Traffic; D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D000792:Angiography; D002445:Celiac Artery / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013157:Splenic Artery; D013997:Time Factors; D014057:Tomography, X-Ray Computed