Title |
Acute fissuration of a giant splenic artery aneurysm detected by point-of-care ultrasound: case report
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Published in |
The Ultrasound Journal, February 2018
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DOI | 10.1186/s13089-018-0086-3 |
Pubmed ID | |
Authors |
Philippe Le Conte, David Trewick, Philippe Pes, Eric Frampas, Eric Batard, Winfocus-France Group |
Abstract |
Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vascular disease. Point-of-care ultrasound (POCUS) could be performed in such situation. A healthy 66-year-old man with no previous medical history was admitted to the Emergency Department for a rapid onset epigastric pain. He reported taking non-steroidal anti-inflammatories for 1 week prior to admission. His pain had rapidly subsided and the physical examination was inconclusive. ECG and blood samples were normal. POCUS revealed a vascular mass located between the spleen and the left kidney measuring 80 * 74 mm associated with small amounts of free peritoneal fluid. Computed tomography diagnosed a fissurated giant aneurysm of the splenic artery. The aneurysm was managed emergently by endovascular exclusion by selective splenic artery embolization. The post-intervention course was uneventful and the patient was discharged home 3 days later. The patient has remained free from any complications of the embolization 6 months after the procedure. Spontaneously regressive epigastric pain with a normal physical and biology/ECG should not necessarily reassure the physician, in particular if patients have cardiovascular risk factors. A POCUS should be considered for these patients. |
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Unknown | 2 | 33% |
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Scientists | 1 | 17% |
Mendeley readers
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Unknown | 2 | 50% |
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Nursing and Health Professions | 1 | 25% |
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