Peripancreatic pseudoaneurysm and splenic infarction are rare but life-threatening complications of chronic pancreatitis. The incidence of pseudoaneurysm in patients who undergo angiography for pancreatitis is about 10%. Clinically, pseudoaneurysm is hard to discover until rupture occurs. The authors have recently experienced a case of intact pseudoaneurysm and splenic infarction in chronic alcoholic pancreatitis. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatitis. We managed these complications successfully by distal pancreatectomy and splenectomy.
Adult ; Aneurysm, False/diagnosis/*etiology/surgery ; Case Report ; Human ; Male ; Pancreatectomy ; Pancreatitis, Alcoholic/*complications ; Splenectomy ; *Splenic Artery/surgery ; Splenic Infarction/diagnosis/*etiology/surgery

We present a case of intrapancreatic accessory splenic infarction in a 28-year-old woman. It was discovered during a workup for an acute right epigastric pain. Computed tomography imaging of abdomen demonstrated a hemorrhagic high attenuation with enhancing solid portion in the tail of pancreas. The clinical and radiological differential diagnosis included pancreatic mucinous cystic neoplasm, pancreatic endocrine neoplasm, solid pseudopapillary tumor, ductal adenocarcinoma, and metastasis. A distal pancreatectomy was completed. The microscopic examination revealed heterotopic splenic tissue with infarction and her abdominal pain disappeared. In this case report, we first describe a symptomatic accessory splenic infarction which presented as a hemorrhagic mass in the tail of pancreas mimicking pancreatic neoplasm.
Adult ; Diagnosis, Differential ; Female ; Hemorrhage/etiology ; Humans ; Pancreas/pathology/surgery ; Pancreatectomy ; Pancreatic Diseases/*diagnosis/pathology/surgery ; Pancreatic Neoplasms/diagnosis ; Spleen/pathology ; Splenic Infarction/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed