Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7907
Peer-review started: January 5, 2015
First decision: January 22, 2015
Revised: February 23, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: July 7, 2015
Splenic arteriovenous fistulas (SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography (CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient’s recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.
Core tip: This is the first reported case of a splenic arteriovenous fistula occurring after laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for these fistulas, especially when are associated with splenic venous aneurysms.