A CASE REPORT OF ANEURYSM OF THE SPLENIC ARTERY DIAGNOSED BY ENDOSCOPIC ULTRASONOGRAPHY

Abstract

A 56-year-old female was admitted because of a gastric protruded lesion on upper GI series. Laboratory data showed no abnormal findings. Endoscopy demonstrated a protruded lesion resembling submucosal tumor (SMT), 1cm in size, at the posterior wall of greater curvature of fundus. Biopsy of submucosal tissue was planned, but was not performed. Because endoscopic ultrasonography (EUS) performed before biopsy demon-strated that the lesion was not SMT but extragastric vessel mass. Celiac angiography showed an anuerysm of the splenic artery, 1.1 × 0.9 cm of size located at the posterior wall of fundus. We diagnosed an aneurysm of the splenic artery which oppressed the gastric wall and had the impression of a SMT endoscopically. An extragastric mass sometimes appears like a SMT. Recently several new methods such as ethanol injection have been developed to evaluate histologically SMT of the stomach. However, they sometimes have serious complications because the lesion could be an extragastric mass, especially vessel lesion in some cases. Ultrasonography and EUS are useful examinations to differentiate extragastric mass from SMT.