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Splenosis involving the gastric fundus, a rare cause of massive upper gastrointestinal bleeding: a case report and review of the literature

View Article: PubMed Central - PubMed

ABSTRACT

Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. The following case report describes a patient presenting with a massive upper gastrointestinal bleed resulting from arterial enlargement within the gastric fundus secondary to perigastric splenosis. The cause of the bleeding was initially elusive and this case highlights the importance of a thorough clinical history when faced with a diagnostic challenge. Treatment options, including the successful use of transarterial embolization in this case, are also presented.

No MeSH data available.


Related in: MedlinePlus

Selective angiogram and embolization of a gastric branch of the left phrenic artery perfusing the largest splenic nodule.Notes: (A) Selective angiogram of a markedly enlarged gastric branch of the left phrenic artery perfusing the largest splenic nodule of a grouping of perigastric splenosis (arrow). The dashed line approximates the component of the artery traversing the wall of the gastric fundus. (B) Selective angiogram following successful embolization of the gastric branch with multiple coils (arrows). The dashed arrow identifies ascending branch of left inferior phrenic artery.
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f2-ceg-9-301: Selective angiogram and embolization of a gastric branch of the left phrenic artery perfusing the largest splenic nodule.Notes: (A) Selective angiogram of a markedly enlarged gastric branch of the left phrenic artery perfusing the largest splenic nodule of a grouping of perigastric splenosis (arrow). The dashed line approximates the component of the artery traversing the wall of the gastric fundus. (B) Selective angiogram following successful embolization of the gastric branch with multiple coils (arrows). The dashed arrow identifies ascending branch of left inferior phrenic artery.

Mentions: The patient continued to have melena stool and a subsequent CT angiogram was acquired revealing an extensive network of enlarged arteries within the wall of the gastric fundus that were supplying a grouping of splenosis along the posterior aspect of the gastric fundus (Figure 1). The dominant arterial supply was localized to a branch of the left inferior phrenic artery, which underwent successful transarterial coil embolization that was confirmed on a follow-up CT scan (Figures 1 and 2). The patient clinically improved, his hemoglobin stabilized, and he was ultimately discharged home.


Splenosis involving the gastric fundus, a rare cause of massive upper gastrointestinal bleeding: a case report and review of the literature
Selective angiogram and embolization of a gastric branch of the left phrenic artery perfusing the largest splenic nodule.Notes: (A) Selective angiogram of a markedly enlarged gastric branch of the left phrenic artery perfusing the largest splenic nodule of a grouping of perigastric splenosis (arrow). The dashed line approximates the component of the artery traversing the wall of the gastric fundus. (B) Selective angiogram following successful embolization of the gastric branch with multiple coils (arrows). The dashed arrow identifies ascending branch of left inferior phrenic artery.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036825&req=5

f2-ceg-9-301: Selective angiogram and embolization of a gastric branch of the left phrenic artery perfusing the largest splenic nodule.Notes: (A) Selective angiogram of a markedly enlarged gastric branch of the left phrenic artery perfusing the largest splenic nodule of a grouping of perigastric splenosis (arrow). The dashed line approximates the component of the artery traversing the wall of the gastric fundus. (B) Selective angiogram following successful embolization of the gastric branch with multiple coils (arrows). The dashed arrow identifies ascending branch of left inferior phrenic artery.
Mentions: The patient continued to have melena stool and a subsequent CT angiogram was acquired revealing an extensive network of enlarged arteries within the wall of the gastric fundus that were supplying a grouping of splenosis along the posterior aspect of the gastric fundus (Figure 1). The dominant arterial supply was localized to a branch of the left inferior phrenic artery, which underwent successful transarterial coil embolization that was confirmed on a follow-up CT scan (Figures 1 and 2). The patient clinically improved, his hemoglobin stabilized, and he was ultimately discharged home.

View Article: PubMed Central - PubMed

ABSTRACT

Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. The following case report describes a patient presenting with a massive upper gastrointestinal bleed resulting from arterial enlargement within the gastric fundus secondary to perigastric splenosis. The cause of the bleeding was initially elusive and this case highlights the importance of a thorough clinical history when faced with a diagnostic challenge. Treatment options, including the successful use of transarterial embolization in this case, are also presented.

No MeSH data available.


Related in: MedlinePlus