Rapid progression of a splenic aneurysm due to segmental arterial mediolysis: a rare cause of acute pancreatitis.
BACKGROUND
The etiology of acute pancreatitis can be manifold, beside the usual causes. We are reporting an unusual cause that triggered acute pancreatitis.
A 50 year-old male experienced attacks of acute pancreatitis (abdominal pain and elevated amylase and lipase) during sexual arousal. Serial imaging showed a rapidly-progressing, partly-thrombosed splenic artery aneurysm, with local compression of the pancreas. After angiographic coiling, the attacks subsided. Further angiography revealed additional aneurysms consistent with segmental arterial mediolysis at other sites of the body. Molecular analysis regarding Ehlers-Danlos-syndrome and genetic factors for pancreatitis, autoantibodies and Syphilis serology was negative.


CONCLUSIONS
Acute pancreatitis was triggered by a transient rise in blood pressure during sexual stimulation, which caused rapid progression of a splenic artery aneurysm as part of systemic segmental arterial mediolysis.
Gastrocentrum, Karolinska Institute & University Hospital Huddinge, Stockholm, Sweden; Dept. of Medicine II, University Medical Center Mannheim, University of Heidelberg, Germany. Electronic address: matthias.lohr@ki.se.
J-Matthias
JM
Löhr
Dietmar
D
Dinter
Steffen J
SJ
Diehl
Stephan L
SL
Haas
Mira
M
Veeser
Roland
R
Pfützer
Jürgen
J
Retter
Stefan O
SO
Schönberg
Christoph
C
Düber
Volker
V
Keim
Dirk
D
Schadendorf
Heiko
H
Witt
D015746:Abdominal Pain / Q000209:etiology; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D017542:Aneurysm, Ruptured / Q000150:complications; D001794:Blood Pressure; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000209:etiology*; D011859:Radiography; D015642:Radiology, Interventional; D020018:Sexual Dysfunctions, Psychological / Q000150:complications; D013157:Splenic Artery
Acute pancreatitis; Hypertension; Segmental arterial mediolysis; Sexual arousal; Splenic artery aneurysm