EURORAD ESR

Case 10258

Subcapsular splenic haematoma: a rare complication of pancreatitis

Author(s)
Sergio Savastano1, Mario Salvagnini2, Mario Beghetto1, Alessandra Costantini1, Roberto Castaman2, Giuseppe Mansi1, Stefano Da Pozzo1

U.O. di Radiologia1, U.O. Gastroenterologia2 - Ospedale San Bortolo - v.le F. Rodolofi 37 36100 Vicenza, Italy; Email:sergio.savastano@ulssvicenza.it
 
Patient
male, 41 year(s)
 
 
  • Figure 1
    Contrast enhanced CT of the abdomen.
     

    The pancreatic tail is slightly enlarged and enveloped by a peripancreatic fluid collection. Narrowing of the splenic vein is also appreciable (arrow).

     
    Area of Interest: Pancreas; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Diffusion of the fluid collection within the gastro-splenic ligament is appreciable on a more cephalad section. Fatty infiltration of the liver is also evident.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Contrast enhanced CT of the abdomen after the second hospitalisation.
     

    Large inhomogeneous subcapsular fluid collection of the spleen.

     
    Area of Interest: Spleen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Coronal multiplanar reformation. A small left pleural effusion is present; no evidence of fatty infiltration of the liver.

     
    Area of Interest: Spleen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Para-axial MIP shows patency of the splenic vein.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 3
    CT follow up after 2 months.

    Partial reabsorption of the subcapsular splenic collection.

     
    Area of Interest: Spleen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
  • Figure 4
    MRI follow up 5 months later
     

    Axial T1 out-of-phase GE image shows progressive decrease in size of the subcapsular splenic haematoma. Hyperintense rim indicates deposits of methaemoglobin.

     
    Area of Interest: Spleen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Axial TSE T2wi depicts inhomogeneity of the residual subcapsular collection.

     
    Area of Interest: Spleen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;

    Coronal CE 3DSPGR shows well the decrease in size of the subcapsular splenic hematoma. Enhancement of the parietal peritoneum of the left hypocondrium is also appreciable.

     
    Area of Interest: Spleen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haemorrhage;
     
     
The pancreatic tail is slightly enlarged and enveloped by a peripancreatic fluid collection. Narrowing of the splenic vein is also appreciable (arrow).
 
Diffusion of the fluid collection within the gastro-splenic ligament is appreciable on a more cephalad section. Fatty infiltration of the liver is also evident.
 
Large inhomogeneous subcapsular fluid collection of the spleen.
 
Coronal multiplanar reformation. A small left pleural effusion is present; no evidence of fatty infiltration of the liver.
 
Para-axial MIP shows patency of the splenic vein.
 
Partial reabsorption of the subcapsular splenic collection.
 
Axial T1 out-of-phase GE image shows progressive decrease in size of the subcapsular splenic haematoma. Hyperintense rim indicates deposits of methaemoglobin.
 
Axial TSE T2wi depicts inhomogeneity of the residual subcapsular collection.
 
Coronal CE 3DSPGR shows well the decrease in size of the subcapsular splenic hematoma. Enhancement of the parietal peritoneum of the left hypocondrium is also appreciable.
 
 
 
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