Abstract • A patient with recurrent upper gastrointestinal bleeding was found to have pancreatitis and a pseudoaneurysm of the splenic artery that communicated with the pancreatic duct. Similar pathology noted in ten other patients found in an extensive review of the literature suggest that this rare entity must be considered in the diagnosis of gastrointestinal hemorrhage of obscure origin. In this collected experience, the combination of recurrent left upper quadrant pain, a history of pancreatitis, and recurrent bouts of gastrointestinal bleeding of obscure origin were usually present in those patients who were found to have a splenic artery aneurysm as the source of the blood loss. Distal pancreatectomy with resection of the splenic artery aneurysm is curative. (Arch Surg 113:751-753, 1978) References 1. Sandblom P: Gastrointestinal hemorrhage through the pancreatic duct . Ann Surg 171:61-66, 1970.Crossref 2. Longmire WP, Rose AS: Hemoductal pancreatitis . Surg Gynecol Obstet 136:246-250, 1973. 3. Koehler PR, Nelson JA, Berenson MM: Massive extra-enteric gastrointestinal bleeding: Angiographic diagnosis . Radiology 119:41-44, 1976.Crossref 4. Walter JF, Chuang VP, Bookstein JJ, et al: Arteriography of massive hemorrhage secondary to pancreatic disease . Radiology 124:337-342, 1977.Crossref 5. Lower WE, Farrell JI: Aneurysm of the splenic artery: Report of case and review of the literature . Arch Surg 23:182-190, 1931.Crossref 6. Hentel W: Ruptured splenic artery aneurysm . Rocky Mt Med J 63:48-50, 1966. 7. Jones EL, Finney GG: Splenic artery aneurysms: A reappraisal . Arch Surg 97:940-947, 1968.Crossref 8. Boijsen E, Efsing H-O: Aneurysm of the splenic artery . Acta Radiol 8:29-41, 1969. 9. Soeno T, Kakizak G, Fujiwara Y, et al: Massive hemorrhage into the upper digestive tract due to rupture of splenic artery aneurysm into the pancreas . Am J Gastroenterol 61:55-62, 1974. 10. Bowers J, Koehler PR, Hammar SP, et al: Rupture of splenic artery aneurysm into the pancreatic duct . Gastroenterology 70:1152-1155, 1976. 11. Stanley JC, Thompson NW, Fry WJ: Splanchnic artery aneurysms . Arch Surg 101:689-697, 1970.Crossref 12. Stanley JC, Fry WJ: Pathogenesis and clinical significance of splenic artery aneurysms . Surgery 76:898-909, 1974. 13. Babb RR: Aneurysm of the splenic artery . Arch Surg 111:924-925, 1976.Crossref 14. MacFarlane JR, Thorbjarnarson B: Rupture of splenic artery aneurysm during pregnancy . Am J Obstet Gynecol 95:1025-1037, 1966.
Archives of Surgery – American Medical Association
Published: Jun 1, 1978