Page 50 - Virtual Vascular Vol 2 Sep 2020-f
P. 50

Peripheral Arterial Disease



                                                                                                                                                                    Splenic Artery Pseudoaneurysm

                                                                           elayed presentation of chronic
                                                                      Datherosclerotic occlusive disease is
                                                                      a common problem in Hong Kong.   This
                                                                      patient had what appeared to be dry
                                                                      gangrene of his left 3rd and 4th toes,                                                                        A heavy drinker with chronic pancreatitis. A
                                                                      and severe resting pain.                                                                                      CT findings of 4cm splenic artery
                                                                                                                                                                                    pseudoaneurysm.  This is likely to be a
                                                                      Many of these patients are elderly, had                                                                       complication from previous attacks of acute

                                                                      multiple comorbidities, diabetic and                                                                          pancreatitis.  The splenic artery is in close
                                                                      was not given proper care when early                                                                          proximity to the pancreas.
                                                                      symptoms of critical ischemia devel-
                                                                      oped.


                                                                      Close inspection revealed infection of
                                                                      the plantar spaces in the forefoot and
                                                                      urgent ray resection and debridement
                                                                      was necessary.  This created significant

                                                                      tissue loss and the risk of major ampu-
                                                                      tation is very high                                                                                                                    Pseudoaneurysm
                                                                                                                                     Left gastric artery                         Splenic artery











































                                                                                                                                                                                                                          Celiac artery
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                                                                                                                                                                                                                        Aorta
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