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      Life‐threatening gastrointestinal bleeding from splenic artery pseudoaneurysm due to gastric ulcer penetration treated by surgical hemostasis with resuscitative endovascular balloon occlusion of the aorta: A case report

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          Abstract

          We report the case of a patient for whom surgical hemostasis of gastrointestinal bleeding due to a splenic artery pseudoaneurysm, which developed due to gastric ulcer penetration, was achieved with resuscitative endovascular balloon occlusion of the aorta without ischemia of organs including the spleen.

          Abstract

          Upper gastrointestinal bleeding caused by ruptured splenic artery pseudoaneurysms (SAPs) confers a significant risk. Thus, strategies involving resuscitative endovascular balloon occlusion of the aorta play a crucial role in treating ruptured SAPs.

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          Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature.

          Richard J Fowl, D Tessier, Edwin M. Stone … (2003)
          Splenic artery pseudoaneurysm is uncommon. We report our institution's recent 18-year experience with these aneurysms and review the literature. We reviewed the records for 37 patients with visceral artery pseudoaneurysm evaluated at our institution from 1980 to 1998. From this group we found only 10 patients (27%) with splenic artery pseudoaneurysm. We also reviewed 147 cases of splenic artery pseudoaneurysm reported in the English literature. In this series of 10 patients, 5 were men. Mean age was 51.2 years (range, 35-78 years). Causes of aneurysm included chronic pancreatitis in 4 patients, trauma in 2 patients, iatrogenic cause in 1 patient, and unknown cause in 3. The most common symptom was bleeding in 7 patients and abdominal or flank pain in 5 patients; 2 patients had no symptoms. Aneurysm diameter was known for four pseudoaneurysms, and ranged from 0.3 to 3 cm (mean, 1.7 cm). Splenectomy and distal pancreatectomy were performed in 4 patients, splenectomy alone in 2 patients, endovascular transcatheter embolization in 2 patients, and simple ligation in 1 patient. One patient with a ruptured pseudoaneurysm died before any intervention could be performed; there were no postoperative deaths. Follow-up data were available for 7 patients, with a mean of 46.3 months (range, 4.5-120 months). Splenic artery pseudoaneurysm is rare and usually is a complication of pancreatitis or trauma. Average aneurysm diameter in our series of 10 patients was smaller than previously reported (1.7 cm vs 5.0 cm). Although conservative management has produced excellent results in some reports, from our experience and the literature, we recommend repair of all splenic artery pseudoaneurysms.
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            Resuscitative Endovascular Balloon Occlusion of the Aorta and Resuscitative Thoracotomy in Select Patients with Hemorrhagic Shock: Early Results from the American Association for the Surgery of Trauma’s Aortic Occlusion in Resuscitation for Trauma and Acute Care Surgery Registry

            Joannis Baez Gonzalez, Zhengwen Xiao, Elizabeth Dauer … (2018)
            Aortic occlusion is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage.
            Article 0 comments Cited 52 times – based on 0 reviews     Review now
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              Resuscitative endovascular balloon occlusion of the aorta for non-traumatic intra-abdominal hemorrhage

              Melanie R Hoehn, Natasha Hansraj, Amelia Pasley … (2018)
              Hemorrhagic shock is the second leading cause of death in blunt trauma and a significant cause of mortality in non-trauma patients. The increased use of resuscitative endovascular balloon occlusion of the aorta (REBOA) as a bridge to definitive control for massive hemorrhage has provided promising results in the trauma population. We describe an extension of this procedure to our hemodynamically unstable non-trauma patients.
              Article 0 comments Cited 19 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Tomonori Nakata:
                ORCID: https://orcid.org/0000-0001-8013-2297
                t-nakata@wakayama-med.ac.jp
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 10 March 2022
                Publication date Collection: March 2022
                Volume: 10
                Issue: 3 ( doiID: 10.1002/ccr3.v10.3 )
                Electronic Location Identifier: e05561
                Affiliations
                [ 1 ] ringgold 13145; Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan
                Author notes
                [*] [* ] Correspondence

                Tomonori Nakata, Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811‐1 Kimiidera, Wakayama 641‐8509, Japan.

                Email: t-nakata@ 123456wakayama-med.ac.jp

                Author information
                https://orcid.org/0000-0001-8013-2297
                Article
                Publisher ID: CCR35561
                DOI: 10.1002/ccr3.5561
                PMC ID: 8908089
                PubMed ID: 35310302
                SO-VID: 598e5eb4-a551-4480-a695-b753ae5a70c7
                Copyright © © 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date revision received : 17 February 2022
                Date received : 03 February 2022
                Date accepted : 19 February 2022
                Page count
                Figures: 5, Tables: 0, Pages: 5, Words: 2327
                Categories
                Subject: Case Report
                Subject: Case Reports
                Custom metadata
                source-schema-version-number 2.0
                cover-date March 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.2 mode:remove_FC converted:10.03.2022

                Keywords: aneurysm,balloon occlusion,non‐traumatic hemorrhage,shock,surgical hemostasis
                Data availability:
                Keywords: aneurysm, balloon occlusion, non‐traumatic hemorrhage, shock, surgical hemostasis

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