Splenic artery aneurysm as a rare cause of an upper GIT bleed

Morare, Nolitha; Bosman, Charl; Ogunrombi, AB

doi:10.1136/bcr-2019-232383

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rupture of SAAs is typically detected as bleeding into the lesser sac, peritoneal space, and adjacent areas. [ 6 ] Fistulation with vascular structures like the splenic and portal veins can cause arteriovenous fistulae. These fistulae can cause a mesenteric steal phenomenon, resulting in insufficient blood supply to the small bowel and subsequent ischemia.…”

Section: Introductionmentioning

confidence: 99%

Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: A rare case report

Zain,

Sires,

Al-Jawad

et al. 2024

Medicine

View full text Add to dashboard Cite

Introduction: Splenic artery aneurysm (SAA) is a focal dilation of the splenic artery with varying etiologies including atherosclerosis, arteritis, or trauma. Giant SAAs with a diameter of 10 cm is rare and can lead to severe complications like rupture and fistulas. Therefore, an accurate and timely diagnosis and treatment are important. Patient concerns: A 50-year-old male presented with acute epigastric pain and hemorrhagic shock. Considering his symptoms and examination, ultrasound, multi-slice computed tomography and digital subtraction angiography results, a ruptured giant splenic artery aneurysm complicated with an exceptional gastric and transverse colonic fistula was suspected. Diagnosis: Ruptured giant splenic artery aneurysm. Interventions: Left anterolateral thoracotomy to control the severe aortic bleeding just above the diaphragm, aneurysmectomy, splenectomy, and closing the gastric and transverse colon perforations. Outcomes: Multi-slice computed tomography demonstrated the presence of splenic artery aneurysm in the distal third measuring (10 × 12 cm) in diameter with a true lumen measuring (7 × 3.5 cm) and a large hematoma extending to the greater and lesser gastric curvature. Intraoperatively, a large pulsating mass was detected occupying the epigastrium and the left hypochondrium with severe adhesions with the stomach and transverse colon. Conclusion: Giant SAA with a diameter of 10 cm is rare and is associated with severe complications. Therefore, successful treatment of splenic artery aneurysms involves prompt diagnosis, immediate surgical intervention to control bleeding, and tailored approaches like thoracotomy to control the thoracic aorta for better hemodynamic stabilization, aiming to eliminate the aneurysm and reduce complications effectively.

show abstract

Section: Introductionmentioning

confidence: 99%

Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: A rare case report

Zain,

Sires,

Al-Jawad

et al. 2024

Medicine

View full text Add to dashboard Cite

show abstract

Giant Splenic Artery Aneurysm – An Analysis of the Recent Literature

Salati,

Rather

2024

View full text Add to dashboard Cite

Objective. This article was composed to review the profile of giant splenic artery aneurysm as reported in the recent literature. Methodology. A systematic literature search was conducted through electronic databases and scientific networking sites, including PubMed, Scopus, and Google Scholar, using the key words and terms “giant splenic artery aneurysm”, “large splenic artery aneurysm”, and “huge splenic artery aneurysm”. Only literature in English was considered for inclusion in this study, and the time frame was fixed between 2014 and 2024. Results. 16 cases, including 9 (56.25%) females and 7 (43.75%) males, ranging in age from 35 to 84 years (mean 60.4±13.4 years). Years were included in the review. The size of aneurysm varied from 10 cm to 30.68 cm (mean 12.54±5.32 cm). Upper abdominal pain was the commonest presentation, along with shock and palpable lumps. The majority of the cases (n = 11; 68.7%) were managed by laparotomy, and an endovascular approach was adopted in 4 (25%) cases. Conclusion. Giant splenic artery aneurysm (GSAA) is a rare but potentially life-threatening condition. Physicians need to be aware of this condition so that a diagnosis is made promptly. There is no role of conservative management, and all giant aneurysms need appropriate treatment after detection. Open surgical aneurysmectomy is the mainstay of management.

show abstract

The Definition, Diagnosis, and Management of Giant Splenic Artery Aneurysms and Pseudoaneurysms: A Systematic Review

Rinaldi,

Illuminati,

Caronna

et al. 2024

JCM

View full text Add to dashboard Cite

Background/Objectives: Giant splenic artery aneurysms (SAAs) and pseudoaneurysms (SAPs) represent rare conditions, characterized by a diameter greater than or equal to 5 cm. The risk of rupture is increased compared to common SAAs and SAPs, necessitating urgent treatments to prevent it. Methods: This systematic review was conducted through a comprehensive search involving the PubMed, Google Scholar, and Scopus databases. A total of 82 patients and 65 articles were included in the analysis. For each patient, we investigated age, sex, symptoms, comorbidities, the presence of a true or a false aneurysm, the dimensional criteria used to define dilations as giant aneurysms or pseudoaneurysms, the dimension of the two greatest diameters, imaging studies, surgical treatment, post-operative length of stay (LOS), and post-operative follow-up. Results: The results revealed a similar incidence in both genders (43 males vs. 39 females) with a median age of 55.79 years. The most frequently described symptom was pain (59.76%). Thirteen cases were false aneurysms and 69 were true aneurysms. The mean greatest diameter was 9.90 cm. The CT scan was the most utilized imaging study (80.49%). Open, endovascular, and hybrid surgery were performed in 47, 26, and 9 patients, respectively, with complication rates of 14.89%, 23.08%, and 22.22% occurring for each treatment. The post-operative LOS was 12.29 days, 2.36 days, and 5 days, respectively. The median follow-up was 17.28 months overall. No recanalization was observed after endovascular procedures during the follow-up period. Conclusions: The dimensional criterion to define SAAs and SAPs as giant was most frequently that at least one diameter was ≥ 5 cm. The CT scan was the most frequently utilized radiological study to diagnose giant SAAs and SAPs. Finally, endovascular procedures, open surgeries, and hybrid treatments presented similar post-operative complication rates. The post-operative LOS was lower for the endovascular group, and the follow-up period did not show aneurysm recanalization in any patients.

show abstract

Splenic artery aneurysm as a rare cause of an upper GIT bleed

Cited by 3 publications

References 8 publications

Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: A rare case report

Ruptured giant splenic artery aneurysm with an exceptional concurrent gastric and transverse colonic fistula: A rare case report

Giant Splenic Artery Aneurysm – An Analysis of the Recent Literature

The Definition, Diagnosis, and Management of Giant Splenic Artery Aneurysms and Pseudoaneurysms: A Systematic Review

Contact Info

Product

Resources

About