case_images: PMC9108461_01
case_images: (A) Computed tomography (CT). Coeliac artery dissection spread to the splenic artery, leading to a splenic aneurysm. (B) Endoscopic retrograde cholangiopancreatography (ERCP). An oval structure was imaged close to the pancreatic duct near the pancreatic tail. (C) Plain CT after ERCP. The splenic aneurysm was filled with contrast medium, revealing communication between the main pancreatic duct and the aneurysm. (D) Pancreatography of the resected specimen showed that the fistula was completely resected with the splenic aneurysm. (E) According to histopathological examination, no sign of segmental arterial mediolysis was observed. The pancreatic duct communicated with the haematoma and its lumen was filled with a clot. Chronic pancreatitis was not found.
case_images: gr1.jpg
case_images: PMC9108461_01_gr1.jpg
case_images: fig1
case_images: Computed tomography (CT) revealed indications of coeliac artery dissection and a splenic aneurysm, which was saccular and 20 mm in diameter (Fig. 1A). Pancreatography of the resected specimen confirmed that the fistula was completely resected (Fig. 1D). The pancreatic duct proximal to the aneurysm was filled with a clot (Fig. 1E).
case_images: PMC9108461_02
case_images: (A) Computed tomography (CT). Coeliac artery dissection spread to the splenic artery and formed a splenic aneurysm. (B) The false lumen (arrow) severely oppressed the true lumen (arrow head) but re-entered it, causing no ischaemia. (C) Angiography. The false lumen was successfully embolised using the isolation technique, and the true lumen (arrow) was preserved. (D) Follow up CT. The false lumen was successfully thrombosed to shrink (arrow head) and splenic infarction was limited to a small area.
case_images: gr2.jpg
case_images: PMC9108461_02_gr2.jpg
case_images: fig2
case_images: He suffered from the same symptoms 2 months later, and CT showed no significant changes in coeliac artery dissection and the splenic aneurysm (Fig. 2A and B). Target XL  360 (Stryker, Portage, MI, USA), Interlock  (Boston Scientific, Marlborough, MA, USA), and Tornade  (Cook Medical, Bloomington, IN, USA) was performed for the false lumen using the isolation technique (Fig. 2C). The false lumen was successfully thrombosed, and splenic infarction was limited to a small area on the follow up CT (Fig. 2D).