Ueda T, Murata S, Yamamoto A, Tamai J, Kobayashi Y, Hiranuma C, Yoshida H, Kumita SI. Endovascular treatment of post-laparoscopic pancreatectomy splenic arteriovenous fistula with splenic vein aneurysm. World J Gastroenterol 2015; 21(25): 7907-7910 [PMID: 26167091 DOI: 10.3748/wjg.v21.i25.7907]
Corresponding Author of This Article
Tatsuo Ueda, MD, PhD, Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. s9015@nms.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tatsuo Ueda, Satoru Murata, Shin-ichiro Kumita, Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku, Tokyo 113-8602, Japan
Akira Yamamoto, Jin Tamai, Yuko Kobayashi, Chiaki Hiranuma, Department of Radiology, Nippon Medical School Tama Nagayama Hospital, Tama City, Tokyo 206-8512, Japan
Hiroshi Yoshida, Department of Surgery, Nippon Medical School Tama Nagayama Hospital, Tama City, Tokyo 206-8512, Japan
Author contributions: Ueda T performed the endovascular treatment and designed the report; Yamamoto A, Tamai J, Kobayashi Y and Hiranuma C read the CT scans and interventional images; Yoshida H performed the surgery; Ueda T organized the report and wrote the paper; Murata S and Kumita S revised the content of the paper.
Informed consent statement: The patient provided informed consent for the treatment.
Conflict-of-interest statement: The authors declare no conflicts of interest. This research did not receive any specific funding.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tatsuo Ueda, MD, PhD, Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. s9015@nms.ac.jp
Telephone: +81-3-58146240 Fax: +81-3-56851795
Received: January 4, 2015 Peer-review started: January 5, 2015 First decision: January 22, 2015 Revised: February 23, 2015 Accepted: April 17, 2015 Article in press: April 17, 2015 Published online: July 7, 2015
Abstract
Splenic arteriovenous fistulas (SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography (CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient’s recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.
Core tip: This is the first reported case of a splenic arteriovenous fistula occurring after laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for these fistulas, especially when are associated with splenic venous aneurysms.
