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Reminder of important clinical lesson
Unusual presentation of spontaneous splenic haematoma due to severe pancreatitis: a cautionary tale
  1. Karthik Purushothaman1,
  2. David W Borowski2
  1. 1Department of General Surgery, University Hospital North Tees, Stockton on Tees, UK
  2. 2Department of Colorectal Surgery, University Hospital North Tees, Stockton on Tees, UK
  1. Correspondence to David W Borowski; DWBorowski{at}


We report the case of a patient with multiple splenic complications from chronic pancreatitis with pseudocyst formation, including splenic vein thrombosis, subcapsular splenic haematoma and splenic artery pseudoaneurysm. The initial presentation was associated with pleuritic chest pain, clinically resembling symptoms of pulmonary embolism. The patient was treated with therapeutic low-molecular-weight heparin, without confirmatory imaging. However, the latter arranged computed tomographic pulmonary angiogram was negative, while the abdominal sequences of the CT revealed the splenic haematoma as causative pathology. The patient was initially treated conservatively, and discharged from inpatient care. On a subsequent CT, a pseudoaneurysm of the splenic artery was found and treated with coil embolisation. The patient is currently awaiting definitive management of the pancreatic pseudocyst.

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