Percutaneous Endovascular Management of a Splenic Vein Pseudoaneurysm Secondary to Pancreatic Pseudocyst

Abstract

A 74-year-old male patient with remote history of severe gallstone pancreatitis underwent cholecystectomy and distal pancreatectomy. The surgical intervention was complicated by postsurgical chronic collection/pseudocyst that was managed conservatively. Patient presented to emergency room with anaerobic bacterial sepsis. Abdominal imaging demonstrated peripancreatic collection with new air bubble and surrounding inflammatory changes suggestive of infected pseudocyst. Computed tomography (CT) also revealed interval development of splenic vein pseudoaneurysm protruding into the collection. Splenic vein pseudoaneurysm was successfully treated with covered stent using transhepatic percutaneous endovascular approach prior to planned endoscopic transgastric drainage of the pancreatic pseudocyst. Clinical Impact This case report sheds light on a rare complication of pancreatitis, splenic vein pseudoaneurysm. The pseudoaneurysm was successfully treated percutaneously using a covered stent. The article also emphasizes the utilization and safety of transhepatic approach to interventions related to portal vein and its tributaries.