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DOI: 10.1055/a-2582-4085
Exposure of an obstructed splenic artery aneurysm stent into the duodenum
A 76-year-old man with a history of splenic artery aneurysm and celiac artery aneurysm was referred for a screening esophagogastroduodenoscopy (EGD). An endovascular stent had been placed for the splenic artery aneurysm 5 years previously ([Fig. 1]), and coiling had been performed in the stent lumen 4 months previously [1] ([Fig. 2]).
EGD revealed exposure of a metal mesh in the duodenum, which was thought to be the endovascular stent that had been placed in a splenic artery aneurysm ([Fig. 3]); no obvious bleeding was observed. Contrast-enhanced computed tomography was performed, but blood flow within the stent could not be evaluated owing to artifacts caused by the stent, and detailed observation was also difficult with transabdominal ultrasonography [2]. Therefore, endoscopic ultrasonography (EUS) was performed from within the stomach, taking care not to directly affect the exposed stent, and we were able to evaluate the stent through the metal mesh, with acoustic shadow but no obvious blood flow seen in the lumen on Doppler echo [3] ([Fig. 4]; [Video 1]).
Surgical removal of the exposed stent was considered, but the patient was judged to be unsuitable for this owing to his severe co-morbidities. Instead, observation was chosen because of the fact that he had been able to manage oral intake without any problems.
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Publication History
Article published online:
06 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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References
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- 2 Boschmann H, Zimmermann HB, Wiechmann T. et al. Ruptured splenic artery aneurysm – a rare cause of recurrent gastrointestinal hemorrhages [in German]. Med Klin (Munich) 2001; 96: 351-354
- 3 Tannoury J, Honein K, Abboud B. et al. Splenic artery aneurysm presenting as a submucosal gastric lesion: A case report. World J Gastrointest Endosc 2016; 8: 496-500