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Splenic rupture caused by pancreatic pseudocyst successfully treated by endoscopic ultrasound-guided drainage

Abstract

A 43-year-old man was admitted to a local hospital because of acute left abdominal pain. Chronic alcoholic pancreatitis and a 10-cm pancreatic pseudocyst in the tail of the pancreas had been found 5 years previously. He had not stopped drinking alcohol since then. On admission, laboratory tests revealed severe anemia, and contrast-enhanced computed tomography showed extravasation in the pancreatic pseudocyst. The spleen was retracted by the pancreatic pseudocyst, and its configuration was indistinct. The patient was diagnosed with acute bleeding within the pancreatic pseudocyst and splenic rupture. He was transferred to our university hospital on an emergency basis. Abdominal angiography of the splenic artery was immediately performed, but the bleeding point was not found. Although the bleeding stopped spontaneously, an infection of the pancreatic pseudocyst and a splenic hematoma subsequently developed. Endoscopic ultrasound-guided pseudocyst drainage was performed. The infection improved after the drainage, and the size of the pancreatic pseudocyst and splenic hematoma decreased. Five months later, the pancreatic pseudocyst had almost disappeared, and the splenic hematoma was even smaller. We herein report a rare case of splenic rupture caused by a pancreatic pseudocyst. Although the patient’s condition became complicated by severe infection, treatment by endoscopic ultrasound-guided drainage was successful.

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Abbreviations

EUS:

Endoscopic ultrasound

CT:

Computed tomography

LAMS:

Lumen-apposing metal stent

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Acknowledgement

We thank Angela Morben, DVM, ELS, from Edanz Group (https://en-author-services.edanzgroup.com/), for editing a draft of this manuscript.

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Correspondence to Naoyuki Hasegawa.

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Naoyuki Hasegawa, Yoshimi Ito, Masamichi Yamaura, Masato Endo, Kazunori Ishige, Kuniaki Fukuda, Ichinosuke Hyodo, Yuji Mizokami declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Hasegawa, N., Ito, Y., Yamaura, M. et al. Splenic rupture caused by pancreatic pseudocyst successfully treated by endoscopic ultrasound-guided drainage. Clin J Gastroenterol 13, 981–984 (2020). https://doi.org/10.1007/s12328-020-01152-1

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  • DOI: https://doi.org/10.1007/s12328-020-01152-1

Keywords

  • Splenic rupture
  • Pancreatic pseudocyst
  • EUS-guided drainage