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Unusual presentation of more common disease/injury
Case report
Splenic artery aneurysm as a rare cause of an upper GIT bleed
  1. Nolitha Makapi Tisetso Morare1,
  2. Charl Bosman2 and
  3. Akinwumi Babatunde Ogunrombi3,4
  1. 1 General Surgery, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
  2. 2 General Surgery, Klerksdorp Tshepong Hospital Complex, Klerksdorp, South Africa
  3. 3 General Surgery, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
  4. 4 General Surgery, Klerksdorp Tshepong Hospital Complex, Klerksdorp, South Africa
  1. Correspondence to Dr Nolitha Makapi Tisetso Morare; nmorare{at}gmail.com

Abstract

Upper gastrointestinal bleeding (UGIB) is a common life-threatening presentation in the emergency department. Causes are typically divided into variceal and non-variceal bleeds. Non-variceal pathologies typically include bleeding peptic ulcers, haemorrhagic gastritis and Mallory Weiss Tears. Occassionally, less common pathologies are encountered such as Dieulafoy’s lesions, haemosuccus pancreas, haemobilia or aorto-enteric fistula. The following report documents the case of a 49-year-old man who presented with an UGIB. His risk factors included a history of nonsteroidal anti-inflammatory drug, smoking and ethanol abuse. Despite his typical presentation and risk factors, investigation revealed an unusual and rare pathology. He was found to have a giant splenic artery aneurysm, abutting and eroding the gastric mucosa. Diagnosis was made using a combination of gastro-oesophagoscopy and CT scan. Successful treatment consisted of angio-embolisation of the aneurysm.

  • gastrointestinal bleeding
  • visceral aneurysm
  • hematemesis
  • vascular abnormalities

https://doi.org/10.1136/bcr-2019-232383

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    Footnotes

    • Contributors NMTM and ABO were responsible for the management and investigation of the patient. NMTM and CB wrote the manuscript with support from BzawO. CB was responsible for the follow-up of the patient and imaging. ABO helped supervise the project and provided critical revision of the article. All of the authors are responsible for the final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.