Massive upper gastrointestinal bleeding due to giant splenic artery aneurysm with gastric fistula

Abstract

We aimed to report a case of a giant splenic artery aneurysm (SAA) with gastric fistula with the review of the literature. A female patient with splenic artery aneurysm was admitted to our hospital with abdominal pain and massive upper gastrointestinal bleeding. Hemorrhagic shock occurred. Despite the resuscitation, the patient died. Splenic artery aneurysms are the most common visceral aneurysm occurring predominantly in females with a ratio of 4: 1. Giant aneurysm with thrombosis of the splenic artery is an extremely rare clinical entity and its size rarely exceeds to 3 centimeters. Although they are usually asymptomatic, SAA are clinically important because of the possibility of life-threatening rupture. Interventions or surgical treatment is indicated for symptomatic and giant aneurysms. Early diagnosis and prompt intervention is necessary for success of treatment.

Keywords

• Splenic artery, aneurysm, gastric fistula, hemorrhagic shock

Mideye fistülize dev splenik arter anevrizmasina bağli masif üst gastrointestinal sistem kanamasi

Abstract

Nadir görülen mideye fistülize olmuş dev splenik arter anevrizmasına bağlı masif üst gastrointestinal sistem kanaması ile başvuran bir olguyu sunmayı istedik. Splenik arter anevrizması olan kadın hasta hastanemize karın ağrısı ve üst gastrointestinal sistem kanaması ile getirildi. Hastada hemorojik şok mevcuttu. Yapılan tüm resusitasyon çabalarına rağmen hasta hayatını kaybetti. Splenik arter anevrizmaları nadir görülmekle birlikte, kadınlarda erkeklere göre 4 kat daha fazla görülen ve iç organ anevrizmaları içerisinde en sık karşılaşılan anevrizmalardır. Splenik arterin tromboze ve dev anevrizmaları ise oldukça ender görülüp, nadiren 3 cm'ye ulaşırlar. Genellikle asemptomatik olsalar da, hayatı tehdit edebilecek yırtılmaları nedeniyle klinik olarak oldukça önemlidirler. Bu hastaların tedavisindeki başarıda, erken tanı, cerrahi ya da diğer girişimsel yöntemler önemlidir.

Keywords

• Splenik arter, anevrizma, mide fistülü, hemorojik şok

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