Acute pancreatitis (AP) is a relatively common condition most often secondary to excess alcohol consumption, choledocholithiasis, medications, or hypertriglyceridemia. In rare cases, AP can result in a secondary splenic artery pseudoaneurysm (SAP). SAPs are a rare yet serious medical complication and are often under-diagnosed as they are usually asymptomatic. However, rupture and subsequent hemorrhage of SAPs pose life-threatening risks. This case involves a 72-year-old male presenting with portal vein thrombosis and recurrent episodes of AP with persistently elevated levels of lipase of no apparent etiology over a 6-month period. As patient history and pertinent test results ruled out all common causes of recurrent AP, the etiology of his AP remained unknown. After an SAP rupture and emergency treatment with an endovascular stent, the patient's recurrent AP spontaneously resolved, and lipase returned to normal levels. This case represents a yet-to-be-reported etiology of AP in which the proximal nature of the SAP with its associated inflammatory response to the pancreas resulted in intermittent AP. The lack of any other reasonable explanation for the etiology of the patient's recurrent AP along with the absence of any additional episodes after the treatment of his SAP supports this diagnosis. The findings of this case could prove useful to clinicians with patients suffering from recurrent episodes of AP with no known etiology and suggest that a potential undiagnosed SAP should be investigated further.
Keywords: acute pancreatitis (ap); acute pancreatitis complications; portal vein thrombosis (pvt); recurrent acute pancreatitis; splenic artery pseudoaneurysm.
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