Splenic Artery Aneurysm Rupture

Abstract

Background: Splenic artery aneurysms are uncommon even though they are second only to those of the aorto-iliac system. There is also controversy regarding their management. Methods: We report the case of a 50-year-old patient with ruptured splenic artery aneurysm and review the literature regarding its diagnosis and management. Results: The patient underwent emergency laparotomy and splenectomy was performed. Conclusion: Resuscitation and an aggressive surgical approach should be taken in order to save the life of the patients.

Spontaneous rupture of an isolated splenic artery aneurysm: an unusual cause of an acute abdomen

“…Moreover, the third most common abdominal aneurysm is an SAA. [5] Seventy-two percent of them are true aneurysms, with most being saccular in nature, [4] and they occur predominantly in multiparous women. [2] The etiology of SAAs may be associated with a congenital weakness of the arterial wall, such as fibromuscular dysplasia or Ehlers-Danlos syndrome, hormonal and hemodynamic changes during the pregnancy, portal HT, systemic vasculitis, or atherosclerosis.…”

“…Up to 80% of patients with SAAs are asymptomatic. The other 20% are admitted to hospitals with a wide range of nonspecific symptoms, including abdominal pain, nausea, and vomiting, [5] with left upper quadrant/epigastric pain radiating to the left shoulder being the most common clinical presentation of symptomatic SAAs. In our case, the definitive diagnosis of a ruptured SAA was revealed by CT.…”

“…Rupture is the most lethal complication associated with SAAs, and the chance of this occurring ranges from 2-9% according to Uyar et al [6] Rupture of the aneurysm, which may manifest as a life-threatening hemorrhage, actually occurs in approximately 2% of the patients. [5] In contrast, there is a 28% chance of a rupture for patients with a giant aneurysm. [2] A mortality rate of approximately 20% has been reported when SAAs rupture, [6] and the rupture and mortality risk is even higher when these aneurysms occur during pregnancy.…”

“…In addition, endovascular techniques offer a safe, feasible, nonsurgical alternative for the management of these aneurysms. [5,7] Moreover, Fotopoulos et al [5] reported that great success has been achieved with many nonsurgical interventions involving emergency patients with SAAs.…”

Ruptured Aneurysm of the Splenic Artery: A Rare Cause of Abdominal Pain after Blunt Trauma

“…The pathogenesis of true SAA is not completely understood, but it may be attributed to blunt abdominal trauma, atherosclerosis, mycotic infection, essential hypertension, portal hypertension, diabetes mellitus, chronic pancreatitis, arterial dysplasia , polyarteritis nodosa, pregnancy or liver transplantation ( 1 , 12 ). In contrast to true aneurysms of large arteries, atherosclerosis in true SAA is rarely the primary causative factor ( 13 ). Our patient was not affected by any of the mentioned underlying pathologies.…”