Splenic pseudoaneurysm rupture into the colon: colonoscopy before and after successful arterial embolization

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Abstract
Summary We report a case of splenic pseudoaneurysm rupture into the colon in chronic pancreatitis. At the time of bleeding, pancreatitis was undiagnosed and the colonic lesion was misinterpreted at colonoscopy. The lesion was also misinterpreted at laparotomy, because it simulated intra-abdominal carcinomatosis. The diagnosis was made by CT examination which showed an eccentric enhancing region within a hypodense mass in the region of the splenic hilum. Definitive control of bleeding was achieved by splenic arterial embolization. Splenic infarction and an intrasplenic abscess complicated the embolization, but they did not require surgical intervention. Healing of the colonic wall and of the colonic mucosa was observed at colonoscopy 3 weeks after the embolization.