Powerpoint template for scientific posters (Swarthmore College)

1
Splenic Vein Aneurysm Chronic Pancreatitis A
Rare Association Skaf Jad1, Bhishak
Kamat2 1Division of Internal Medicine, 2Division
of Radiology

• Introduction
• Portal venous system aneurysms, which are the
  most common of the visceral venous aneurysms, are
  defined as a focal saccular or fusiform
  dilatation of the portal venous system. Portal
  venous system aneurysms represent 3 of all
  venous aneurysms. Prevalence is 0.6 per 1,000
  persons. The most common sites at which portal
  venous system aneurysms develop are the main
  portal vein and the confluence of the splenic and
  the superior mesenteric veins. A significant
  number of previously reported cases of portal
  venous system aneurysms were associated with
  liver cirrhosis and portal hypertension. Most
  people with a portal venous system aneurysm are
  asymptomatic.
• Vascular abnormalities associated with
  pancreatitis are well described, up to 50 with
  acute necrotizing pancreatitis, and include
  superior mesenteric and/or portal vein thromboses
  and arterial pseudo-aneurysms. Portal vein
  aneurysms and/or spleno-mesenteric venous
  aneurysms are rare entities.

CT A/P
3D Reconstruction
Focal Dilatation involving the central aspect of
the splenic vein measuring 1.7x1.7 cm.
MR Abdomen
Splenic Vein pseudo-aneurysm measuring 18 mm.
Case History HPI
Fluoroscopy

• We describe a case of a 68 yo female with a
  history of recurrent pancreatitis who presented
  with intractable abdominal pain.
• She was first diagnosed with pancreatitis back in
  August 2007, then underwent cholecystectomy for
  gallstones, but following that she had recurrent
  pancreatitis. She was at an outside hospital for
  a total of 5 weeks for abdominal pain. She
  presented to our institution one day after being
  discharged , complaining of persistent and
  intractable abdominal pain with nausea and
  inability to tolerate per os intake.
• Other PMH is notable for Diabetes Mellitus,
  Hyperlipidemia, Hypertension and Hypothyroidism.

Physical Exam
Treatment Follow-up

• Vitals Temp 97.2, HR 68, BP 149/72, SpO2
  98 on RA
• In Mild Distress (Pain), cachectic
• Abdominal Exam BS present normal, n
• o Organomegaly.
• No rebound tenderness, no guarding, no defense.
• Epigastric Tenderness.
• Rest of physical exam is unremarkable

• Symptoms of Splenic Vein Aneurysms are unusual.
  In our case the patients symptoms were caused by
  the recurrent pancreatitis.
• Complications include rupture and Bleeding.
• Because the incidence of these aneurysms are low,
  the exact type of intervention and the frequency
  of monitoring is unknown.
• Follow-up by Duplex Sonography or CT-Scan is
  recommended every year until regression or a
  stable pattern is recognized.
• Prophylactic surgical intervention or
  decompressive procedures are recommended in
  high-risk aneurysms in such cases where
  mechanical forces such as portal hypertension
  cause progressive enlargement of the aneurysms
  and pain.
• Most cases are managed by simple observation and
  do not progress. In the case of our patient her
  splenic vein aneurysm has been stable in size at
  1 year follow-up.

Amylase 165 Lipase 134 Alkaline
Phos. 77 Bilirubin Total 0.3 Bilirubin Direct
0.1
100
135
4
165
0.7
3.6
26
8.2
ALT 13 AST 22 Albumin 2.8
5.4
244
26.6