ArticleJournal of surgical case reports2026
Splenic artery pseudoaneurysm presenting as massive haematemesis during endoscopic management of post-sleeve gastrectomy leak: a case report.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Visceral artery pseudoaneurysm is a rare, potentially fatal complication of post-sleeve gastrectomy (LSG) staple-line leak. We report a 36-year-old woman who presented with a proximal staple-line leak, managed with laparoscopic washout and endoscopic stenting. During apparent clinical improvement, she experienced sentinel haemorrhage on postoperative Day 30, initially attributed to stent-related mucosal trauma. Catastrophic haemorrhage ensued 2.5 hours later. Endoscopy revealed a clot-filled stent without a mucosal source; computed tomography angiography (CTA) identified a 20 × 18 × 13 mm splenic artery pseudoaneurysm within the perigastric collection. Proximal coil angioembolization achieved complete exclusion without splenic infarction. The patient made a full recovery and was discharged home on postoperative Day 42. This case illustrates a potentially fatal vascular complication arising during active leak management. A splenic artery pseudoaneurysm must be actively sought in any upper gastrointestinal bleeding during post-LSG leak management, and CTA must exclude a vascular source before attributing bleeding to stent-related mucosal trauma.
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