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

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

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Abstract Background nacrack.com 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 2006 nissan altima radio 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.