臨床症例報告ジャーナル

Acute Portal Vein Thrombosis and Pancreatitis: An Adverse Complication of the Embolization of a Splenic Artery Aneurysm

Abstract

Safadi Wajdi, Waksman Igor, Morrison Seth and Salamon Tal

A 45-year-old woman presented with few months history of left upper quadrant abdominal pain radiating to her left shoulder. Computed Tomographic Angiography (CTA) demonstrated two successive splenic artery aneurysms 2.2 and 2.8 cm in diameter in the distal splenic artery. Her symptomatic nature and the aneurysm’s size necessitated proceeding with treatment. The aneurysms were treated by endovascular coil and thrombin embolization. A few hours post-procedure, she developed acute portal vein thrombosis (aPVT), followed by acute pancreatitis and near-total splenic infarction. Treatment with anticoagulant therapy and antibiotics led to a good recovery. She was discharged on warfarin therapy for 6 months. 40 days after embolization, an abdominal CTA revealed a patent portal vein, occlusion of the aneurysms and partial splenic infarction. We present an overview of the natural history, treatment options and side effects of treatment of splenic artery aneurysms.