Acute fissuration of a giant splenic artery aneurysm detected by point-of-care ultrasound: case report

Background 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 situat...

Full description

Saved in:
Bibliographic Details
Published in:Critical ultrasound journal 2018-02, Vol.10 (1), p.5-5, Article 5
Main Authors: Le Conte, Philippe, Trewick, David, Pes, Philippe, Frampas, Eric, Batard, Eric
Format: Article
Language:English
Subjects:
Case Report
Critical Care Medicine
Diagnostic Radiology
Emergency Medicine
Imaging
Intensive
Interventional Radiology
Medicine
Medicine & Public Health
Radiology
Ultrasound
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background 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. Case presentation 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. Conclusion 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.
ISSN:2036-3176
2036-7902
DOI:10.1186/s13089-018-0086-3