Splenic rupture caused by pancreatic pseudocyst successfully treated by endoscopic ultrasound-guided drainage
- PDF / 954,410 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 265 Views
CASE REPORT
Splenic rupture caused by pancreatic pseudocyst successfully treated by endoscopic ultrasound‑guided drainage Naoyuki Hasegawa1 · Yoshimi Ito1 · Masamichi Yamaura1 · Masato Endo1 · Kazunori Ishige1 · Kuniaki Fukuda1 · Ichinosuke Hyodo1 · Yuji Mizokami2 Received: 26 March 2020 / Accepted: 3 June 2020 © Japanese Society of Gastroenterology 2020
Abstract A 43-year-old man was admitted to a local hospital because of acute left abdominal pain. Chronic alcoholic pancreatitis and a 10-cm pancreatic pseudocyst in the tail of the pancreas had been found 5 years previously. He had not stopped drinking alcohol since then. On admission, laboratory tests revealed severe anemia, and contrast-enhanced computed tomography showed extravasation in the pancreatic pseudocyst. The spleen was retracted by the pancreatic pseudocyst, and its configuration was indistinct. The patient was diagnosed with acute bleeding within the pancreatic pseudocyst and splenic rupture. He was transferred to our university hospital on an emergency basis. Abdominal angiography of the splenic artery was immediately performed, but the bleeding point was not found. Although the bleeding stopped spontaneously, an infection of the pancreatic pseudocyst and a splenic hematoma subsequently developed. Endoscopic ultrasound-guided pseudocyst drainage was performed. The infection improved after the drainage, and the size of the pancreatic pseudocyst and splenic hematoma decreased. Five months later, the pancreatic pseudocyst had almost disappeared, and the splenic hematoma was even smaller. We herein report a rare case of splenic rupture caused by a pancreatic pseudocyst. Although the patient’s condition became complicated by severe infection, treatment by endoscopic ultrasound-guided drainage was successful. Keywords Splenic rupture · Pancreatic pseudocyst · EUS-guided drainage Abbreviations EUS Endoscopic ultrasound CT Computed tomography LAMS Lumen-apposing metal stent
Introduction Splenic rupture is a rare but life-threatening complication of chronic and acute pancreatitis [1–4]. In almost all previous reports, a surgical treatment such as splenectomy was performed as a life-saving measure. When the patient’s vital signs are stable and conservative treatment is possible, the clinician must consider the risk of infection of a pancreatic * Naoyuki Hasegawa naoyuki‑[email protected] 1
Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1‑1‑1 Tennoudai, Tsukuba, Ibaraki 305‑8575, Japan
Endoscopic Center, University of Tsukuba Hospital, 2‑1‑1 Amakubo, Tsukuba, Ibaraki 305‑8576, Japan
2
pseudocyst and formation of a hematoma around the spleen. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has recently been described [5]. If splenic rupture caused by a pancreatic pseudocyst leads to severe infection, drainage of the splenic hematoma and pancreatic pseudocyst must be immediately performed. To date, however, few reports have described the use of EUS-guided drainage to successfully treat a
Data Loading...
