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TL;DR
This case report describes a 2-year-old male with a pancreatic mass initially thought to be pancreatitis, which was later diagnosed as segmental arterial mediolysis (SAM) after surgical resection and histopathological examination.
JPGN Reports · 5 authors, 5 centres
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This case report describes a 2-year-old male with a pancreatic mass initially thought to be pancreatitis, which was later diagnosed as segmental arterial mediolysis (SAM) after surgical resection and histopathological examination.
This is a single case report of a 2-year-old male who presented with abdominal pain, fever, and vomiting, leading to a diagnosis of acute pancreatitis. An MRI identified a 3-cm pancreatic head lesion. Six months later, he was readmitted with recurrent pancreatitis; an enlarged lesion compressing the portal vein was found. The patient underwent surgical resection, including a pancreatoduodenectomy and portal vein resection. Histopathology of the resected specimen showed an abnormal artery with segmental loss of the elastic lamina and tunica media, consistent with a ruptured aneurysm secondary to SAM. No recurrence was observed on follow-up imaging over 2 years. The report highlights SAM as a rare, noninflammatory vasculopathy to consider in the differential for pediatric pancreatic masses or vasculopathies after excluding other etiologies.