Spontaneous Rupture of Splenic Artery Aneurysm: Case Report

İlkeli, Ekin; Çapçı, Selim; Çinar, Tarhan; Koç, Ayşegül; Mavioglu, Ilhan; Dikmengil, Murat

doi:10.9739/uvcd.2013-37821

Cited by 3 publications

(3 citation statements)

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“… 12 , 16 , 69 Spontaneous SAA rupture often results in sudden pain in the upper-left quadrant, epigastrium, or left shoulder (due to diaphragmatic irritation), and hemodynamic instability related to hypovolemic shock. 4 , 12 Pregnancy, clinically symptomatic aneurysm, diameter ≥2 cm, increase in diameter, surgical treatments influencing portal system pressure (e.g., portocaval shunt), portal hypertension, and liver transplantation are among the leading risk factors for rupture. 28 Of the 78 giant SAA cases in this study, intraperitoneal or retroperitoneal rupture was diagnosed in 15 (19.2%) patients during preoperative radiological studies or intraoperative exploration.…”

Section: Discussionmentioning

confidence: 99%

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Management of Giant Splenic Artery Aneurysm

2015

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To provide an overview of the medical literature on giant splenic artery aneurysm (SAA).The PubMed, Medline, Google Scholar, and Google databases were searched using keywords to identify articles related to SAA. Keywords used were splenic artery aneurysm, giant splenic artery aneuryms, huge splenic artery aneurysm, splenic artery aneurysm rupture, and visceral artery aneurysm. SAAs with a diameter ≥5 cm are considered as giant and included in this study. The language of the publication was not a limitation criterion, and publications dated before January 15, 2015 were considered.The literature review included 69 papers (62 fulltext, 6 abstract, 1 nonavailable) on giant SAA. A sum of 78 patients (50 males, 28 females) involved in the study with an age range of 27–87 years (mean ± SD: 55.8 ± 14.0 years). Age range for male was 30–87 (mean ± SD: 57.5 ± 12.0 years) and for female was 27–84 (mean ± SD: 52.7 ± 16.6 years). Most frequent predisposing factors were acute or chronic pancreatitis, atherosclerosis, hypertension, and cirrhosis. Aneurysm dimensions were obtained for 77 patients with a range of 50–300 mm (mean ± SD: 97.1 ± 46.0 mm). Aneurysm dimension range for females was 50–210 mm (mean ± SD: 97.5 ± 40.2 mm) and for males was 50–300 mm (mean ± SD: 96.9 ± 48.9 mm). Intraperitoneal/retroperitoneal rupture was present in 15, among which with a lesion dimension range of 50–180 mm (mean ± SD; 100 ± 49.3 mm) which was range of 50–300 mm (mean ± SD: 96.3 ± 45.2 mm) in cases without rupture. Mortality for rupture patients was 33.3%. Other frequent complications were gastrosplenic fistula (n = 3), colosplenic fistula (n = 1), pancreatic fistula (n = 1), splenic arteriovenous fistula (n = 3), and portosplenic fistula (n = 1). Eight of the patients died in early postoperative period while 67 survived. Survival status of the remaining 3 patients is unclear. Range of follow-up period for the surviving patients varies from 3 weeks to 42 months.Either rupture or fistulization into hollow organs risk increase in compliance with aneurysm diameter. Mortality is significantly high in rupture cases. Patients with an evident risk should undergo either surgical or interventional radiological treatment without delay.

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Section: Discussionmentioning

confidence: 99%

“…The most frequent management options for SAAs are medical treatment, close follow-up, open surgery, endovascular treatment, and laparoscopic surgery. 1 , 4 – 9 The aim of this review was to provide an overview of the medical literature on giant splenic artery aneurysm (SAA).…”

Section: Introductionmentioning

confidence: 99%

Management of Giant Splenic Artery Aneurysm

2015

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“…On the other side, pancreatic cysts are usually localised around the pancreas, but sometimes can spread into other organs such as spleen, liver, colon, pararenal space, retroperitoneal cavity and mediastinum (4,6,7). Infi ltration of spleen and intracystic bleeding (as in our case) is very rare.…”

Section: Discussionmentioning

confidence: 61%

Coincidence of splenic vein aneurysm and haemorrhagic cyst of the pancreas

Bakos¹,

Jankovic²,

Korcek³

et al. 2022

BLL

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Pseudoaneurysm of the splenic vein is a rare entity which is associated with pancreatitis in 52 % cases. Pseudocysts of the pancreas create approximately 70 % of all cystic lesions of the pancreas. One of the most dangerous complications of pancreatic pseudocysts is bleeding into the cystic lumen. This is caused by perforation of the pseudoaneurysm of the splenic vein. Enzymatic damage of the splenic vein´s wall is the cause of pseudoaneurysm. The clinical condition varies. It can be asymptomatic or bring about haemodynamic instability. The diagnostic process of pseudoaneurysm of the splenic vein is diffi cult. This case study introduces a case of a 50-year-old man with the anamnesis of recurrent pancreatitis caused by alcoholism. He had abdominal pain and was diagnosed with a pseudocyst of the pancreas. Abdominal CT showed an extensive capsulated collection in the left subphrenic space, 23cm in diameter, with serosanguineous content and coagulations. The CT visualised the mass effect on the surrounding tissues and a complete deformation of the spleen. Between the collection and partially oppressed tail of the pancreas there was a venous pseudoaneurysm, 3.5cm in diameter. Considering its localization, it most probably originated from the splenic vein. Surgery was done. We did distal resection of the pancreas with a complete removal of the pseudocyst and spleen (Fig. 7, Ref. 11).

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