case_images: PMC6381554_01
case_images: CT image; pancreatic tail lesion.
case_images: CRIGM2019-8528906.001.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.001.jpg
case_images: fig1
case_images: Due to her history of diverticulitis a CT scan of abdomen and pelvis was obtained which revealed a 6.9 x 6.1 cm cystic mass in the tail of the pancreas (Figure 1).
case_images: Endoscopy image; extrinsic bulge with erythematous mucosa.
case_images: CRIGM2019-8528906.002.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.002.jpg
case_images: fig2
case_images: There was a small central ulceration and erythematous surrounding mucosa (Figure 2).
case_images: EUS image; pancreatic tail lesion with anechoic component.
case_images: CRIGM2019-8528906.003.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.003.jpg
case_images: fig3
case_images: On EUS, a hypoechoic 5 x 5.15 cm lesion with internal anechoic component (Figure 3) was seen in the tail of the pancreas.
case_images: Bleeding splenic artery pseudoaneurysm seen on angiogram.
case_images: CRIGM2019-8528906.004.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.004.jpg
case_images: fig4
case_images: Selective splenic artery angiogram confirmed a pseudoaneurysm with active hemorrhage (Figure 4).
case_images: Post coil embolization angiogram with no bleeding.
case_images: CRIGM2019-8528906.005.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.005.jpg
case_images: fig5
case_images: Coil embolization was performed with 6 mm x 7 cm; 3 mm x 7 cm (2), 3 mm x 5 cm (3) Nester   coils (6 total); postembolization angiography demonstrated no leakage from SAP as well as no forward flow in the splenic artery (Figure 5).
case_images: Endoscopy image; ulcer located in distal duodenum.
case_images: CRIGM2019-8528906.006.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.006.jpg
case_images: fig6
case_images: EGD was done 5 days later for ongoing drop in hemoglobin with persistent melena. EGD showed no abnormalities in the stomach; therefore the scope was advanced into deep duodenum where a large deep ulcer was seen in the fourth part of the duodenum (Figure 6).
case_images: Coronal CT abdomen image showing vascular coils in close proximity of distal duodenum.
case_images: CRIGM2019-8528906.007.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.007.jpg
case_images: fig7
case_images: Multimodality imaging confirmed embolization coil to be in close proximity to the distal duodenum/proximal jejunum (Figure 7) further confirming the site of erosion of SAP in distal duodenum.
case_images: CT image: infarcted spleen.
case_images: CRIGM2019-8528906.008.jpg
case_images: PMC6381554_01_CRIGM2019-8528906.008.jpg
case_images: fig8
case_images: Near complete splenic infarction was confirmed at 2 months on follow-up CT scan (Figure 8).