title: Delayed rupture of a splenic artery pseudoaneurysm after biliopancreatic diversion.
abstract: Splenic artery pseudoaneurysm (SAP) is a known but rare complication of pancreatitis and blunt abdominal trauma. SAP caused by operative trauma has been rarely reported. We present a patient who presented with massive upper gastrointestinal (GI) bleed in shock. On exploratory laparotomy, a SAP was diagnosed. He must have sustained injury to his splenic artery while undergoing reinforcement of sleeve gastrectomy during an open biliary pancreatic diversion procedure 2 years back. Alternatively, the prolene suture might have eroded into the splenic artery to cause the SAP. Literature on iatrogenic SAP is reviewed. SAP should be considered in patients with history of foregut surgery with GI bleed and equivocal endoscopic findings.
authors.affiliation: Department of Surgery, Creighton University, Omaha, NE 68131, USA. kpupadhyaya@gmail.com
authors.forename: Prashant K
authors.initials: PK
authors.lastname: Upadhyaya
authors.forename: Soujanya
authors.initials: S
authors.lastname: Chava
authors.forename: Syed
authors.initials: S
authors.lastname: Bin-Sangheer
authors.forename: Ranjan
authors.initials: R
authors.lastname: Sudan
authors.forename: Sumeet K
authors.initials: SK
authors.lastname: Mittal
authors.forename: Samuel
authors.initials: S
authors.lastname: Cemaj
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015904:Biliopancreatic Diversion / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D013157:Splenic Artery; D013997:Time Factors