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An uninvited guest
Pedro Antunes, Tânia Carvalho, João Soares, Bruno Gonçalves
Serviço de Gastrenterologia do Hospital de Braga
A 74-year-old male with a walled-off pancreatic necrosis, identified on computed tomography (CT) (figure 1), was proposed to endoscopic ultrasound-guided drainage. A trans-gastric 15x10mm lumen-apposing metal stent (LAMS) was placed and a tubular and pulsatile structure traversing the cavity was observed (figure 2), corresponding to the splenic artery as confirmed by CT angiography (figure 3). Patient was admitted for surveillance, after discussion with interventional radiology in case of emergent artery embolization was needed due to major bleeding. LAMS was removed after 3 weeks, with no complications registered, and two double-pigtail plastic stents were then placed. Patient now remains asymptomatic.
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