Splenic artery aneurysm masquerading as upper gastrointestinal bleeding: A rare case report

Introduction and importance: Splenic artery aneurysm is extremely rare but potentially life threatening disease which poses great challenge in diagnosing due to non-specific nature of clinical presentation. Rarely, it presents with upper gastrointestinal bleeding i.e. hematemesis and melena.

Case presentation: A 58-years-old male presented with three and half month history of black tarry stool and abdominal pain, who was initially diagnosed as erosive gastritis and managed with antacids and PPI. After few months of resolution of symptoms, he experienced light-headedness, severe epigastric pain and syncopal episodes. That led to further imaging study which revealed splenic artery aneurysm with celiac artery dissection for which he underwent splenectomy after failure two repeat embolization intervention. Postoperative recovery was smooth, and he remained asymptomatic on follow-up.

Clinical discussion: Though, there is constant risk of SAA to rupture, in our case pressure exerted by aneurysm on celiac artery caused dissection and upper GI bleeding. Endovascular technique is preferred technique but surgery reserved as options in case of failure.

Conclusion: This case highlights the complexities in diagnosing and treating life threating splenic artery aneurysm with celiac artery dissection.