Embolization of splenic artery aneurysm associated with gastrointestinal bleeding: case report

Abstract

The splenic artery is the visceral vessel that is most often affected by aneurysmal disease. Occasionally, gastrointestinal bleeding may signify that the aneurysm is in communication with the digestive tract. We report on the case of a 64-year-old multiparous patient with intermittent digestive bleeding caused by a splenic artery aneurysm who was successfully treated with endovascular embolization.Keywords: Splenic artery; aneurysm; hemorrhage gastrointestinal; embolization therapeutic. ResumoA artéria esplênica é o vaso visceral mais acometido pela doença aneurismática. Ocasionalmente, um sangramento gastrointestinal pode refletir uma comunicação entre o aneurisma de artéria esplênica e o trato digestivo. Relatamos o caso de uma paciente de 64 anos com hemorragia digestiva intermitente devida a aneurisma de artéria esplênica, a qual foi submetida ao tratamento endovascular por embolização com sucesso.

Splenic Artery Aneurysm (SAA) Rupture in Pregnancy: A Case Report of a Rare but Life-Threatening Obstetrical Complication

“…The open surgical approach remains the gold standard approach for SAA repair, mainly when the aneurysm is located in the distal portion of the artery, or in the case of giant aneurysms where other approaches, such as endovascular treatment, would be suboptimal [29]. An alternative is the endovascular approach that has recently gained a lot of popularity with a variety of techniques and the advantage of a less invasive approach especially in patients that exhibit a high surgical risk; however, it is not without complications [30]. Also, there are no data on long term follow up of patients where the endovascular approach was used and there are no reports where these treatment modalities were used in ruptured SAA in pregnancy [30].…”

“…An alternative is the endovascular approach that has recently gained a lot of popularity with a variety of techniques and the advantage of a less invasive approach especially in patients that exhibit a high surgical risk; however, it is not without complications [30]. Also, there are no data on long term follow up of patients where the endovascular approach was used and there are no reports where these treatment modalities were used in ruptured SAA in pregnancy [30]. The laparoscopic approach is a safe therapeutic alternative for cases of elective splenic aneurysm repair; it carries the advantage of the rapid recovery, shorter hospital stay, and less postoperative pain compared with the open approach [31].…”

A benign gastric ulcer eroding into a splenic artery pseudoaneurysm presenting as a massive upper gastrointestinal bleed

“…If the patients' hemodynamic status permits, preoperative diagnosis can be helpful to the surgeon in performing the optimal intervention for this condition. Standard over-sewing of a ‘bleeding gastric ulcer’ would leave the patient's underlying etiology untreated and almost certain to rebleed and needing repeat intervention [ 1 ].…”