Skip to main content

Advertisement

SpringerLink
Log in

Splenic artery pseudoaneurysm following chemotherapy in a patient with pancreatic cancer: a case report

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

A 48-year-old man presented with epigastralgia and back pain. Radiological evaluation revealed a pancreatic tail tumor with contrast enhancement and an intratumoral fluid component involving the splenic artery and invading the left kidney. Endoscopic ultrasound-guided fine-needle aspiration biopsy revealed an adenocarcinoma, and based on invasion of the left kidney, the patient was diagnosed with unresectable pancreatic cancer with suspected peritoneal dissemination. Radiological evaluation performed after the administration of eight courses of gemcitabine combined with nab-paclitaxel revealed stable disease without distant metastases or peritoneal dissemination. We planned to perform radical resection; however, the patient developed a pseudoaneurysm of the splenic artery preoperatively and initially underwent preoperative coil embolization, followed by radical resection (distal pancreatectomy with combined left nephrectomy and partial resection of the colon and stomach), 11 days after embolization. Histopathological examination of the resected specimen confirmed R0 resection, and the splenic artery pseudoaneurysm associated with pancreatic cancer was attributed to tumor invasion of this vessel. He showed satisfactory postoperative recovery and was discharged on the 24th day after surgery with administration of S-1 adjuvant chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Hackert T, Sachsenmaier M, Hinz U, et al. Locally advanced pancreatic cancer: neoadjuvant therapy with folfirinox results in resectability in 60% of the patients. Ann Surg. 2016;26:457–63.

    Article  Google Scholar 

  2. Satoi S, Yamaue H, Kato K, et al. Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20:590–600.

    Article  Google Scholar 

  3. Heinrich S, Lang H. Neoadjuvant therapy of pancreatic cancer: definitions and benefits. Int J Mol Sci. 2017;18:E1622.

    Article  Google Scholar 

  4. Pasha SF, Gloviczki P, Stanson AW, et al. Splanchnic artery aneurysms. Mayo Clin Proc. 2007;82:472–9.

    Article  Google Scholar 

  5. Sachdev-Ost U. Visceral artery aneurysms: review of current management options. Mt Sinai J Med. 2010;77:296–303.

    Article  Google Scholar 

  6. Nanez L, Knowles M, Modrall JG, et al. Ruptured splenic artery aneurysms are exceedingly rare in pregnant women. J Vasc Surg. 2014;60:1520–3.

    Article  Google Scholar 

  7. White AF, Baum S, Buranasiri S. Aneurysms secondary to pancreatitis. AJR Am J Roentgenol. 1976;127:393–6.

    Article  CAS  Google Scholar 

  8. Furukawa H, Fukushima N, Shimada K. Splenic artery aneurysm secondary to pancreatic carcinoma. Am J Gastroenterol. 2000;95:3659–60.

    Article  CAS  Google Scholar 

  9. Toukouki A, Verbeeck N, Weber J, et al. Intragastric rupture of a splenic artery aneurysm associated with a pancreatic cancer. J Belg Soc Radiol. 2016;100:26.

    Article  PubMed Central  Google Scholar 

  10. Hoshimoto S, Aiura K, Shito M, et al. Successful resolution of a hemorrhagic pancreatic pseudocyst ruptured into the stomach complicating obstructive pancreatitis due to pancreatic cancer: a case report. World J Surg Oncol. 2016;14:46.

    Article  PubMed Central  Google Scholar 

  11. Miao YD, Ye B. Intragastric rupture of splenic artery aneurysms: Three case reports and literature review. Pak J Med Sci. 2013;29:656–9.

    PubMed Central  Google Scholar 

  12. Loffroy R, Guiu B, Cercueil JP, et al. Transcatheter arterial embolization of splenic artery aneurysms and pseudoaneurysms: short- and long-term results. Ann Vasc Surg. 2008;22:618–26.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Kenei Furukawa, Hiroaki Shiba, Yoshihiro Shirai & Katsuhiko Yanaga

  2. Department of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan

    Yusuke Nagata & Masayuki Saruta

Authors
  1. Kenei Furukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Shiba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshihiro Shirai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yusuke Nagata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masayuki Saruta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katsuhiko Yanaga
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KF: collection of data and drafting of the article. HS: revision of the article. YS: collection of data. YN: collection of data. MS: collection of data. KY: revision of the article and final approval of the article.

Corresponding author

Correspondence to Kenei Furukawa.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Human/animal rights

This study was approved by the Ethics Committee of the Jikei University School of Medicine.

Informed consent

This patient provided informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Furukawa, K., Shiba, H., Shirai, Y. et al. Splenic artery pseudoaneurysm following chemotherapy in a patient with pancreatic cancer: a case report. Clin J Gastroenterol 13, 969–972 (2020). https://doi.org/10.1007/s12328-020-01137-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-020-01137-0

Keywords

Search

Navigation