title: Endovascular treatment of post-laparoscopic pancreatectomy splenic arteriovenous fistula with splenic vein aneurysm.
abstract: Splenic arteriovenous fistulas (SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography (CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient's recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Murata
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Tamai
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Hiranuma
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Kumita
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010690:Phlebography / Q000379:methods; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
keywords: Endovascular treatment; Laparoscopic pancreatectomy; Percutaneous transarterial embolization; Splenic arteriovenous fistula; Splenic vein aneurysm