BACKGROUND Visceral arterial aneurysms are rare. Most splenic arterial aneurysms (SAAs) are saccular and are in the distal third of the splenic artery. Suggested major causes of SAAs are atherosclerosis, pregnancy, and inflammation. We report the case of a patient who with a SAA extending almost the full length of his splenic artery. CASE REPORT A solitary true aneurysm that extended almost the entire length of the splenic artery was incidentally detected in an asymptomatic 70-year-old male patient with a history of myasthenia gravis and diabetes mellitus. His SAA was severely calcified, but other arteries showed no calcification. The aneurysm had been slightly enlarged toward the celiac artery for 2 years, and aneurysmectomy and splenectomy were performed. Vascular clips were carefully placed at the intact splenic artery without disturbing arterial flows from the celiac artery. Arterial branch from the SAA was ligated at an intact area, and the pancreatic capsule was densely adherent with the calcified aneurysm wall. The pancreas was preserved, although the pancreatic parenchyma was widely exposed during aneurysmectomy. Pathological examination revealed no atherosclerotic changes. Postoperatively, a pancreatic fistula developed, which was treated by placing an intraperitoneal drain and retrograde pancreatic drainage tube. Nevertheless, the intractable pancreatic fistula triggered a bacteriogenic infection, resulting in intraperitoneal abscess. Continuous local lavage via transnasal continuous infusion and endoscopic transgastric drainage was performed, until the fistula closed. He was healthy at 9 months after surgery. CONCLUSIONS A SAA that had the rare form and solitary origin was treated. Continuous local lavage has a therapeutic potential for a pancreatic juice-related bacteriogenic complication.
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http://dx.doi.org/10.12659/AJCR.915010 | DOI Listing |
Int J Surg Case Rep
January 2025
Karnali Academy of Health Science, Jumla, Nepal.
Introduction And Importance: Splenic artery aneurysm is extremely rare but potentially life threatening disease which poses great challenge in diagnosing due to non-specific nature of clinical presentation. Rarely, it presents with upper gastrointestinal bleeding i.e.
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction: Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP). Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures.
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris-Cité, Clichy, France.
Background: Locally advanced pancreatic adenocarcinomas (LA-PDAC) are more frequently operated now than in the past because of new regimen chemotherapy and improvement in surgical technique. Resection of the coeliac trunk (CT) during pancreatoduodenectomy (PD) or total pancreatectomy (TP) is not routinely done owing to the risk of liver and gastric ischaemia. In this video, a patient with LA-PDAC underwent TP with CT resection and retrograde gastric revascularization through the distal splenic artery.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
Purpose: Our aim was to update evidence-based and consensus-based recommendations for the inhospital endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.
Methods: MEDLINE and Embase were systematically searched to June 2021.
Cureus
December 2024
Obstetrics and Gynecology, First Health Cluster, Dammam, SAU.
Mediastinal lymphangiomas are rare benign tumors arising from lymphatic system malformations, most commonly seen in pediatric populations. In adults, they are exceedingly rare and present diagnostic challenges due to nonspecific symptoms and imaging overlap with other mediastinal masses. Diagnosis is typically based on imaging, including CT and MRI, with histopathology confirming the diagnosis.
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