Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

doi:10.3748/wjg.v12.i26.4264

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Jul 14, 2006 (publication date) through Nov 4, 2024

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Jul 14, 2006; 12(26): 4264-4266
Published online Jul 14, 2006. doi: 10.3748/wjg.v12.i26.4264

Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

Dimitrios Siablis, Zafiria G Papathanassiou, Dimitrios Karnabatidis, Nikolaos Christeas, Konstantinos Katsanos, Constantine Vagianos

Dimitrios Siablis, Zafiria G Papathanassiou, Dimitrios Karnabatidis, Nikolaos Christeas, Konstantinos Katsanos, Constantine Vagianos, Departments of Interventional Radiology and Surgery, University Hospital of Patras, Rio, Greece

Author contributions: All authors contributed equally to the work.

Correspondence to: Professor Dimitrios Siablis, MD, Department of Radiology, Medical School, University of Patras, Rio 26504 Patras, Greece. papaze@otenet.gr

Telephone: +30-261-450723 Fax: +30-261-993987

Received: March 3, 2006
Revised: March 16, 2006
Accepted: March 27, 2006
Published online: July 14, 2006

Abstract

Splenic arteriovenous fistula (SAVF) accounts for an unusual but well-documented treatable cause of portal hypertension^[1-4]. A case of a 50-year-old multiparous female who developed suddenly portal hypertension due to SAVF formation is presented. The patient suffered from repeated episodes of haematemesis and melaena during the past twelve days and thus was emergently admitted to hospital for management. Clinical and laboratory investigations established the diagnosis of portal hypertension in the absence of liver parenchymal disease. Endoscopy revealed multiple esophageal bleeding varices. Abdominal computed tomography (CT) and transfemoral celiac arteriography documented the presence of a tortuous and aneurysmatic splenic artery and premature filling of an enlarged splenic vein, findings highly suggestive of an SAVF. The aforementioned vascular abnormality was successfully treated with percutaneous transcatheter embolization. Neither recurrence nor other complications were observed.

Keywords: Splenic artery aneurysm; Splenic arteriovenous fistula; Portal hypertension; Transcatheter embolization