Pablo Duarte Rodrigues*, Caroline Becker Giacomazzi, João Alfredo Diedrich Neto, Estéfano Aurélio Negri, Matheus Koop, Fábio Luiz Waechter, Uirá Fernandes Teixeira, Marcos Bertozzi Goldoni, Paulo Roberto Ott Fontes, Maria Eduarda Caramori, Bruna Helen Biazi and Eduardo Menegat

Department of Digestive System Surgery, Liver Transplantation at the Santa Casa de Misericórdia of Porto AlegreRio Grande do Sul, Brazil

*Corresponding Author: Pablo Duarte Rodrigues, Department of Digestive System Surgery, Liver Transplantation at the Santa Casa de Misericórdia of Porto AlegreRio Grande do Sul, Brazil.

Received: May 31, 2021; Published: June 15, 2021

Abstract

Pseudoaneurysms originating from visceral arteries are really uncommon, even more when it’s related to pancreatic tuberculosis. The objective of this clinical case report is to present a rare case of a patient with an acute upper gastrointestinal bleeding due to rupture of splenic artery pseudoaneurysm associated with pancreatic tuberculosis. A 37-year-old male patient, undergoing irregular treatment for human immunodeficiency virus infection (HIV) and tuberculosis (TB), was admitted to the emergency room with hematemesis associated with melena and haemodynamic instability. In the workup it was diagnosed a splenic artery pseudoaneurysm but the patient was treated initially by conservative means. The patient evolved later with another episode of bleeding and a formal laparotomy was made. It was identified a pancreatic and spleen mass with a fistula to the gastric fundus - fundus gastrectomy and a body/tail pancreatic resection associated with splenectomy were performed. The pathological specimen analysis identified granulomatous inflammatory process involving pancreatic tissue, lymph nodes, gastric fundus, spleen and perivisceral adipose tissue. The tissue was positive for acid-fast bacilli and the patient had a good outcome after surgery and posterior clinical treatment. Although extremely rare conditions, high suspicion of these pathologies and adequate treatment is imperative for positive outcomes.

Keywords: Tuberculosis; Pancreas; Pseudoaneurysms; Splenic Artery

References

1. Tessier DJ., et al. “Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature”. Journal of Vascular Surgery 38 (2003): 969-974.
2. Kumar PA., et al. “Pancreatic Tuberculosis: A Puzzle for Physicians. A Rare Case and Review of Literature”. Journal of Clinical and Diagnostic Research11 (2016): PD29-PD31.
3. Pitton MB., et al. “Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade”. The European Radiology 25 (2015): 2004-2014.
4. Sharma V., et al. “Pancreatic tuberculosis”. Journal of Gastroenterology and Hepatology 31 (2016): 310-318.
5. Irfan M., et al. “Tuberculous pancreatitis complicated by ruptured splenic artery pseudoaneurysm”. Monaldi Archives for Chest Disease 79 (2013): 134-135.
6. Fan ST., et al. “Tuberculosis of the pancreas: a rare cause of massive gastrointestinal bleeding”. British Journal of Surgery 73 (1986): 373.

Citation

Citation: Pablo Duarte Rodrigues., et al. “Splenic Artery Pseudoaneurysm, Pancreatic Tuberculosis and Acute Upper Gastrointestinal Bleeding: An Association of Rare Pathologies”. Acta Scientific Gastrointestinal Disorders 4.7 (2021): 47-49.

Copyright

Copyright: © 2021 Pablo Duarte Rodrigues., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.