Percutaneous drainage of large subcapsular hematoma of the spleen complicating acute pancreatitis.
The splenic complications associated with acute or chronic pancreatitis are rare, including splenic vein thrombosis, arterial pseudoaneurysm, subcapsular splenic hematoma, and splenic rupture. The management for subcapsular splenic hematoma in pancreatitis remains controversial. We herein report a rare case of large subcapsular splenic hematoma complicating acute pancreatitis, which was successfully treated by ultrasound-guided percutaneous drainage. A 32-year-old male suffered from intermittent epigastric pain radiating to his back. Acute pancreatitis complicated with subcapsular splenic hematoma (15.0 x 13.0 x 9.5 cm) was shown on abdominal computed tomography (CT). He underwent ultrasound-guided percutaneous drainage of the splenic hematoma. The size of the splenic hematoma had reduced to 9.5 x 2.3 cm 10 days later. After 4-week drainage of the hematoma, the abdominal pain improved and the patient was discharged. Follow-up abdominal CT 6 months later showed that the subcapsular splenic hematoma had almost completely resolved. The post-drainage course was smooth, and the patient had no abdominal symptoms at the 1-year follow-up.
Tseng
Chih-Wei
CW
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chen
Chun-Chia
CC
Chiang
Jen-Huey
JH
Chang
Full-Young
FY
Lin
Han-Chieh
HC
Lee
Shou-Dong
SD
D000208:Acute Disease; D000328:Adult; D004322:Drainage / Q000379:methods*; D006406:Hematoma / Q000628:therapy*; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000150:complications*; D013158:Splenic Diseases / Q000628:therapy*; D014057:Tomography, X-Ray Computed