Aneurysm of the Splenic Artery

Bedford, PG; Lodge, Brian

doi:10.1136/gut.1.4.312

Cited by 148 publications

(53 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…The first fetal survival in such a case was reported in 1928 by Mayer [3], and MacLeod and Maurice in 1940 [4] were the first who were able to save the mother. The incidence of splenic artery aneurysm noted at autopsy varies between 0.02 to 10.4% [5][6][7][8][9][10][11][12]. Stanley and Fry [10] found a 0.78% incidence of splenic artery aneurysm revealed by abdominal aortography examinations.…”

Section: Discussionmentioning

confidence: 99%

“…Stanley and Fry [10] found a 0.78% incidence of splenic artery aneurysm revealed by abdominal aortography examinations. Splenic artery aneurysms are more common in women, and splenic artery aneurysms are encountered more frequently in parous than in nonparous women [5,9,11,12].Analysis of all cases reported in the literature [8,[13][14][15][16][17][18][19][20][21][22][23] brought to light 75 cases of splenic artery ruptures in pregnancy. Although extremely rare, this event is more common in pregnancy.…”

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confidence: 99%

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Rupture of Splenic Artery Aneurysm During Pregnancy: Three Case Reports with a Review of the Literature

Algwiser

1991

Ann Saudi Med

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AA Algwiser, Rupture of Splenic Artery Aneurysm during Pregnancy: Three Case Reports with a Review of the Literature. 1991; 11(2): 221-225 Aneurysms of the splenic artery are rare. They remain silent until rupture. Because of their frequent association with pregnancy, this is a topic of special interest to obstetricians, particularly because of the difficulty in diagnosis and because it carries a very high maternal and fetal mortality. We report three cases of ruptured splenic artery aneurysm occurring in the third trimester of pregnancy and puerperium, bringing the total number of cases reported in the literature to 75. Case Reports Patient 1A 32-year-old Saudi woman (para 5, gravida 8) was admitted on 12 October 1987 at 2240 hours. Since 1300 hours she had had shortness of breath, nausea, epigastric and shoulder pain, and abdominal pain, especially over the right iliac fossa. On admission, her temperature was 37°C; pulse, 84 per minute; and blood pressure, 115/70 mm Hg. Fundal height corresponded to 38 weeks' gestation with a cephalic presentation. Fetal heart sounds were audible. The abdomen was soft, and cardiotocography showed a reactive tracing with mild uterine contractions. Vaginal examination revealed a parous cervical os, uneffaced cervix, and a high presenting part. Pulse was 80 per minute; blood pressure, 110/70 mm Hg; there was proteinuria+ but the abdomen was soft. There were no uterine contractions and no bleeding per vaginam. An intravenous line was started and the patient was given 10 mg of metoclopramide hydrochloride intramuscularly and discharged home. At 0815 hours, her condition deteriorated and she was readmitted. She was pale and hyperventilating, and her pulse had risen to 140 per minute with blood pressure dropping to 100/80 mm Hg. Her abdomen became tense and painful, and fetal parts were impossible to palpate. An urgent ultrasound was carried out which was suggestive of abruptio placentae. The patient was rushed to the obstetric theatre for emergency cesarean section. The abdomen was entered through a subumbilical midline incision and about 1,500 ml of blood was encountered in the peritoneal cavity. No bleeding source could be found.A male infant, weighing 2,760 gm with an Apgar score of 5 at 1 minute and 5 at 5 minutes, was delivered by lower-segment cesarean section. After closure of the uterus, there was no evidence of further hemorrhage in the abdominal cavity, so the abdomen was closed. While the patient was still in the recovery room, her condition deteriorated. Her pulse rose, she became pale, and the abdomen became distended. Her hemoglobin dropped to 36 gm/L. In view of this, the abdomen was re-entered through the previous incision, which was extended upward to the left costal margin. Three liters of blood clot were found in the peritoneum. At first the bleeding was thought to originate from the liver or stomach, as the uterus was intact and well contracted, but after blood was evacuated from the abdominal cavity, it was obvious that the source of bleeding was from a ruptu...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Rupture of Splenic Artery Aneurysm During Pregnancy: Three Case Reports with a Review of the Literature

Algwiser

1991

Ann Saudi Med

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“…[1][2][3] The goal of treatment of these aneurysms is to prevent rupture, while maintaining the blood flow. Therefore, the resection of the aneurysm and the reconstruction of the splenic artery by surgery remain the gold standard for fulfilling these goals.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The most common treatment is surgical resection with or without splenic artery reconstruction, or exclusion with catheter intervention, which may reduce postoperative complications, such as pancreas injury. However, when the aneurysm is associated with an arterial anomaly, the treatment becomes complicated, especially if it is presented during pregnancy.…”

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confidence: 99%

Splenic Artery Aneurysm of the Hepatosplenomesenteric Trunk

Sakakibara

Shindo

Matsumoto

et al. 2013

Annals of Vascular Diseases

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A splenic artery aneurysm is the most frequently observed visceral artery aneurysm, with an incidence of 40%-60% of all visceral aneurysms. [1][2][3] The most common treatment is surgical resection with or without splenic artery reconstruction, or exclusion with catheter intervention, which may reduce postoperative complications, such as pancreas injury. However, when the aneurysm is associated with an arterial anomaly, the treatment becomes complicated, especially if it is presented during pregnancy. We herein report the case of a patient with a splenic artery aneurysm of the hepatosplenomesenteric trunk that presented during pregnancy. case reportA 32-year-old female was referred to our hospital due to the development of a visceral artery aneurysm during pregnancy. Abdominal ultrasonography (US) revealed an aneurysm of 2.5 × 3.5 cm located behind the pancreas head. She was already five months pregnant. The contrast-enhanced computed tomography (CT) scans at that time demonstrated a small aneurysm behind the pancreas (Fig. 1A). The celiac axis and superior mesenteric artery were not observed separately, thus suggesting the formation of a common channel by these arteries. The 3D-CT presented a common channel of the hepatic, splenic and superior mesenteric arteries. The left gastric artery originated independently from the aorta. Thus, a splenic aneurysm of the hepatosplenomesenteric trunk was diagnosed (Fig. 1B). The wide neck of the aneurysm and its close location to the orifices of the trunk had indicated a high risk of mesenteric obstruction, although catheter embolization was discussed at that time. Thereafter, the patient stopped visiting the hospital because of the asymptomatic nature of the aneurysm. Surgical treatment was recommended because of the increasing risk of rupture either before or during delivery. However, the patient rejected an operation before delivery even with full informed consent. Therefore, the aneurysm was carefully examined every two weeks by abdominal US. Meanwhile, the obstetrician recommended a Caesarian section at 36 weeks to prevent an aneurysm rupture, which may occur due to the stress and effort associated with transvaginal delivery. The pediatrician and vascular surgeons were standing by, and the delivery by Caesarian section We herein report the case of a splenic artery aneurysm with a hepatosplenomesenteric trunk that presented in a pregnant woman. Catheter embolization was not performed due to the wide neck of the aneurysm and its close location to the trunk indicates a high risk of mesenteric trunk thrombosis. We instead performed surgical resection of the aneurysm after successful delivery of the infant by Caesarian section. The splenic artery was reconstructed by side-to-end anastomosis with the common hepatic artery. Splenic Artery Aneurysm of the Hepatosplenomesenteric Trunk

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Splenic Artery Aneurysms

Jones¹

1968

Arch Surg

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Aneurysm of the Splenic Artery

Cited by 148 publications

References 59 publications

Rupture of Splenic Artery Aneurysm During Pregnancy: Three Case Reports with a Review of the Literature

Rupture of Splenic Artery Aneurysm During Pregnancy: Three Case Reports with a Review of the Literature

Splenic Artery Aneurysm of the Hepatosplenomesenteric Trunk

Splenic Artery Aneurysms

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