Acute gastrointestinal bleeding caused by a ruptured splenic artery aneurysm

BACKGROUND: Splenic artery aneurysms are rare. Symptoms vary from none to acute abdominal pain. Gastrointestinal bleeding is a very rare symptom, but may occur in case of rupture. CASE REPORT: A 69-year-old woman was admitted for haematemesis. A ruptured splenic artery aneurysm was found. The aneurysm had ruptured into the pancreatic duct, causing gastrointestinal bleeding via the papilla of Vater. The patient's aneurysm was treated successfully with endovascular embolisation. DISCUSSION: Selective arteriography is diagnostic for splenic artery aneurysms. Endovascular treatment with embolisation of the aneurysm is the treatment of choice. When duodenoscopy is done in the case of rupture to the pancreatic duct it is mandatory to inspect the papilla of Vater for a sufficient period of time in order to see the bleeding from the papilla. Although rare, a splenic artery aneurysm should be considered in the assessment of patients with diffuse abdominal pain or gastrointestinal bleeding of unknown origin.