Contrast-enhanced Computed Tomography Imaging of Splenic Artery Aneurysms and Pseudoaneurysms: A Single-center Experience

Abstract

Aim:The aim of our study was to evaluate the computed tomography (CT) imaging features of splenic artery aneurysm and pseudoaneurysm and to identify the disease conditions related to the same. We also wanted to ascertain any relationship between these associated disease conditions and the imaging features of the aneurysms.Materials and Methods:This retrospective study included patients diagnosed to have splenic artery aneurysms on contrast-enhanced CT examination between January 2001 and January 2016. Data were obtained from the picture archiving and communication system. The size, number, location, morphology, the presence of thrombosis, calcification, and rupture of the aneurysms were evaluated.Results:A total of 45 patients were identified with a mean age of 45 years. Splenic artery aneurysms were idiopathic in 12 (26.6%) patients. In the remaining patients, the main associated disease conditions included pancreatitis 15 (33%), chronic liver disease with portal hypertension 8 (18%), and extrahepatic portal vein obstruction (EHPVO) 6 (13%). Statistically significant findings included the relationship between EHPVO and multiple aneurysms (P = 0.002), chronic liver disease and fusiform aneurysm (P = 0.008), and smaller size of idiopathic aneurysms (P < 0.001).Conclusion:Based on this study, splenic artery aneurysms were associated with a variety of etiologies. The characteristics of the aneurysms such as size, location, and morphology vary with the associated disease conditions. These variations may have implications for the management.

Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients With Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases

“…( 290,293 ) Associations with pregnancy, portal hypertension, or pancreatitis have been frequently reported. ( 279,290‐292,294,295 ) However, there is undoubtedly a detection bias in the published literature attributable to repeated abdominal imaging performed in such conditions. ( 290,294 ) Commonly reported causes include arteriosclerosis and fibromuscular dysplasia.…”

“…( 279,290‐292,294,295 ) However, there is undoubtedly a detection bias in the published literature attributable to repeated abdominal imaging performed in such conditions. ( 290,294 ) Commonly reported causes include arteriosclerosis and fibromuscular dysplasia. ( 280,290 ) Recently, attention has been drawn to HHT ( 296 ) and the combination of alpha‐1 antitrypsin deficiency and chronic liver disease requiring LT as risk factors.…”

Cross clamping of the supraceliac aorta is effective for bleeding control in ruptured giant splenic artery pseudoaneurysm when proximal and distal control of the splenic artery is not possible: a case report

“…5 Diagnostic modalities for splenic artery aneurysms include Doppler ultra-sound, abdominal CECT, and magnetic resonance imaging (MRI) angiography. 6 Computed tomography angiography is useful for observing the typical aneurysm body in the arterial phase. It is also useful for differentiating splenic artery aneurysms from pancreatic tumors, pseudocysts, solid epithelial tumors, and gastric leiomyomas.…”

Hematemesis in Alcoholics: Not Always the Same Problem. A Case Report of Successful Percutaneous Arterial Embolization of Spontaneously Ruptured Splenic Artery Aneurysm Causing Hematemesis, Hematochezia and Hemodynamic Instability

“…This course of the disease is responsible for 20-25% of all cases of splenic artery aneurysm rupture and usually presents as severe abdominal pain with a subsequent period of clinical stability collapse, followed by sudden collapse. The majority of the lesions are located in the distal third of the splenic artery, and some patients have multiple splenic aneurysms [5]. True aneurysms are treated based on their size, location, and symptoms, whereas all pseudoaneurysms require treatment due to high risk of rupture (25%) and mortality (50%), probably depending on the wall instability [2,6].…”