Splenic artery pseudoaneurysm as a fatal complication of acute pancreatitis

Splenic artery pseudoaneurysm (SAP) is a rare but potentially fatal complication of acute pancreatitis. We present a 67-year-old female with ruptured SAP as a complication of acute pancreatitis. The patient had mild clinical symptoms on admission, thus was difficult to identify for severe complications. However, she had experienced two episodes of hypovolemic shock on the 10th day after admission. Abdominal computer tomography scan and angiography revealed evidence of splenic artery injury possibly due to acute pancreatitis. The patient underwent transcatheter embolization of splenic artery and total spleen. However, she was still hemodynamically unstable and eventually expired due to severe sepsis. This case raised our clinical awareness of SAP as a rare but life-threatening complication of acute pancreatitis even in patients with short clinical courses and initially mild symptoms. SAP should be kept in mind during image study or in hemodynamically unstable cases of acute pancreatitis.