Ruptured splenic artery aneurysm detected by emergency ultrasound—a case report

Lo, Wai Ling; Mok, Ka Leung

doi:10.1186/s13089-015-0026-4

Cited by 11 publications

(16 citation statements)

References 16 publications

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“…The management of SAPAs and true splenic artery aneurysms has long been discussed under the same headings in most studies, although etiological factors, histopathologic features, prevalence as well as gender predominance differ (1,2,8). There is no debate on the point that a rapidly enlarging or ruptured aneurysm requires treatment, whether true or false (8,9). That said, debates on the management of asymptomatic, silent aneurysms are ongoing.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors on this controversial topic have suggested that the mechanism behind the formation of the aneurysm is not a determining factor in the decision making process (9). Albeit less common, some such aneurysms are false, and their natural history may not be well-delineated, leading a significant number of authors to recommend the repair of all SAPAs, regardless of size and symptoms (1,3,8,10). We strongly advocate this view, having witnessed the devastating rupture of a SAPA that was overlook due to its small size.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the rising mortality rate, it has been suggested that pseudocysts reduce the success rate of endovascular interventions, being approximately 85% (1-3), and for this reason, the suitability of TAE for the patients with ruptured pseudocyst-associated SAPA is another source of dispute (2,9). In several reports and in many centers, TAE is not regarded as the first choice treatment for ruptured SAPAs (8). Moreover, TAE is not advised as the rupture may not be limited to the borders of a pseudocyst (6).…”

Section: Discussionmentioning

confidence: 99%

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Re-emergence of a splenic artery pseudoaneurysm following rupture presenting as syncope: management with transarterial embolization

Uzunkaya¹,

Soylu²,

Karabulut³

et al. 2019

Kocaeli Med J

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Splenic artery pseudoaneurysms are rare but potentially lethal disorder. Transarterial embolization has become the preferred mode of therapy for the disorder, however, accompanying walled-off pancreatic fluid collections including pseudocysts can make the management more challenging. Herein, we present the case of a 40-year-old woman presenting with syncope due to the rupture of a splenic artery pseudoaneurysm into a walled-off pancreatic necrotic collection. The pseudoaneurysm that re-emerged at a larger size following the rupture was endovascularly excluded from circulation after a failed attempt. ÖZ Splenik arter psödoanevrizması nadir ancak potansiyel olarak ölümcül bir bozukluktur. Transarteriyel embolizasyon bu bozukluğun tedavisinde tercih edilen yöntem haline gelmiştir, ancak psödokistlerin de içerisinde yer aldığı duvarlı pankreatik sıvı birikimlerinin varlığı bu tedavi yöntemini zorlaştırabilir. Bu yazıda, splenik arter psödoanevrizmasının duvarlı bir pankreatik nekrotik sıvı birikimi içerisine yırtılmasından dolayı senkop şeklinde bulgu veren 40 yaşında kadın olguyu sunuyoruz. Yırtılmayı takiben daha büyük boyutta yeniden ortaya çıkan psödoanevrizma, başarısız bir girişimin arkasından endovasküler yöntemle dolaşımdan uzaklaştırılmıştır.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Re-emergence of a splenic artery pseudoaneurysm following rupture presenting as syncope: management with transarterial embolization

Uzunkaya¹,

Soylu²,

Karabulut³

et al. 2019

Kocaeli Med J

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“…Upper abdominal pain is the most commonly reported symptom for ruptured SAAs [5, 6]. The clinical presentation of unruptured SAA is largely nonspecific and variable [7, 8].…”

Section: Discussionmentioning

confidence: 99%

A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report

et al. 2017

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BackgroundSplenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding.Case presentationA 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable. A third upper gastrointestinal endoscopy detected a pulsatile bulge at the posterior wall of the gastric antrum. A contrast-enhanced computed tomogram of his abdomen detected a splenic artery aneurysm measuring 3 × 3 × 2.5 cm. While awaiting routine surgery, he developed a torrential upper gastrointestinal bleeding and shock, leading to emergency laparotomy. Splenectomy and en bloc resection of the aneurysm with the posterior stomach wall were performed. Histology revealed evidence for a true aneurysm without overt, acute, or chronic inflammation of the surrounding gastric mucosa. He became completely asymptomatic 2 weeks after the surgery.ConclusionsSplenic artery aneurysms can result in recurrent upper gastrointestinal bleeding. The possibility of impending catastrophic bleeding should be remembered when managing patients with splenic artery aneurysms after a minor bleeding. Negative endoscopy and ultrasonography should require contrast-enhanced computed tomography to look for the cause of recurrent upper gastrointestinal bleeding.

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“…Splenic artery aneurysm (SAA) is defined as an abnormal dilatation of splenic artery more than 1 cm in diameter [ 1 ]. It was first reported in 1770 by Beaussier and was described in a living person by Winkler in 1903 [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ]. SAA is an uncommon disease in the general population with incidence ranging from 0.09% in autopsy studies and 0.78% in arteriography studies [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A review of management options for splenic artery aneurysms and pseudoaneurysms

Lim

2020

Annals of Medicine and Surgery

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Background A review of the management of splenic artery aneurysms (SAA). There is no general consensus as to when and what type of intervention should be chosen to treat SAAs. The aim of this study is to investigate the types of intervention for SAAs including complication, reintervention, rupture, mortality after intervention of SAA in a review. Method A literature search was performed using “keywords” in Medline and Embase limited to publications from 2008 to 2018. 289 articles were identified during the initial literature search. 143 articles met the eligibility criteria. 83 articles were included in the quantitative synthesis. Descriptive analysis was performed. Results 576 patients were identified with 588 reported SAAs. The mean ± SD age was 52.6 ± 5.8 years (range 17–85). The mean ± SD size of SAA was 49.9 ± 13.2 mm (range 6–180). Types of intervention reported were endovascular treatment, open surgery, laparoscopic surgery and conservative management. Mortality rate in patients with endovascular treatment was 0.5% compared to 4.9% with open surgery. 3.4% of patients with conservative management were reported to have aneurysms that grew over time and 2.8% patients had further intervention. ANOVA test to compare mortality between open surgery, endovascular treatment and laparoscopic surgery showed there is no difference between mortality between the 3 different interventions as F (2.71) < F crit (3.02) (P = 0.07). Conclusion Endovascular treatment is now the first choice of treatment for SAA, but future studies are required to determine its long-term durability. By introducing a management pathway for SAA, we hope to see an improvement in managing patients. The management algorithm will require further validation through application with careful and complete follow-up of all cases to improve the pathway depending on patient outcome.

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Ruptured splenic artery aneurysm detected by emergency ultrasound—a case report

Cited by 11 publications

References 16 publications

Re-emergence of a splenic artery pseudoaneurysm following rupture presenting as syncope: management with transarterial embolization

Re-emergence of a splenic artery pseudoaneurysm following rupture presenting as syncope: management with transarterial embolization

A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report

A review of management options for splenic artery aneurysms and pseudoaneurysms

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