Splenic artery aneurysm rupture into the colon diagnosed by angiography

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Abstract
Rupture of a splenic artery aneurysm into the colon is a rare complication and causes massive gastro-intestinal haemorrhage. This is the first case in the English literature to have been diagnosed by preoperative angiography and to have survived this condition. A woman aged 43 years, presented to the Accident and Emergency Department at 0500 hours after the passage of a large amount of dark blood per rectum. The bleeding had started two days previously, was intermittent and painless. There had been no haematemesis. She was a woman of no fixed abode who travelled the road from London to Brighton, sleeping rough and drinking large amounts of aleohol. She had been treated for syphilis as a young girl though no records of this exist. She had no children. On examination, she appeared anaemic but not shocked. Pulse 88, BP 100/50. On sigmoidoscopy, the rectum contained large amounts of dark red blood. Haemoglobin on admission was 7.3 g/dJ. Serology showed TPHA positive 1 : 320, VDRL negative, confirming a previous treponemal infection. Subsequent oesophago-gastro-duodenoscopy showed no cause for the bleeding.

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