Giant splenic artery aneurysm associated with arteriovenous malformation

Agrawal, Amit; Whitehouse, Richard W.; Johnson, Robert W.; Augustine, Titus

doi:10.1016/j.jvs.2006.06.049

Cited by 36 publications

(28 citation statements)

References 31 publications

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“…As per the literature,multiple SAA are uncommon accounting for upto 20% of cases [8]. Cavernous transformation of the portal vein is likely to be due to multiple SAA causing extrinsic compression of splenic vein, leading to venous stasis and thrombosis of splenic and portal vein.…”

Section: Discussionmentioning

confidence: 93%

Multiple Splenic Artery Aneurysms: A Rare Cause of Extrahepatic Portal Hypertension and Massive Splenomegaly

Aroor

Raghuraj

et al. 2014

JCDR

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A 39-year-old female presented with one year history of dragging abdominal discomfort and fatigability of six months duration. She was non-alcoholic and had no other medical illness. General physical examination was unremarkable and abdominal palpation suggested splenomegaly of 10 cms below left coastal margin, which was firm and nontender. There was no ascites or hepatomegaly. Examination of other systems was unremarkable.Investigations revealed normal complete blood counts, urine analysis, liver and renal function tests and peripheral smear study. Investigation reports are shown in [Table/ Fig-1]. Ultrasonography (US) with color doppler of abdomen revealed splenomegaly, normal liver echotexture and cavernous transformation of portal vein with multiple spleno-renal collaterals. ECG and echocardiography was normal. Upper gastro-intestinal endoscopy showed grade 1-2 esophageal varices with portal hypertensive gastropathy. Multidetector Computed tomography (MDCT) abdomen revealed multiple aneurysms in the distal half of splenic artery, the largest one measuring (5.1cmx5.8cmx4.4cms) with dilated and tortuous course of the proximal splenic artery with multiple collaterals along the course of splenic and portal vein b,. Wall calcification and organized thrombus was seen in few of the aneurysms at the splenic hilum. DisCussionSplenic artery aneurysms (SAA) are the most common visceral aneurysms, accounting for up-to 60% of cases [1,2]. Splenic artery is the third most common site for intra-abdominal aneurysm after aorta and iliac artery [2]. It has an incidence of 0.01-0.2%, females being more commonly affected (4:1). SAA presenting as extrahepatic portal hypertension is rare [1,3]. Here we report a patient with multiple splenic artery aneurysms presenting as extrahepatic portal hypertension and massive splenomegaly. SAA are very rare with a varied prevalence of 0.01%-10.4% [4]. SAAs are associated with several conditions, including pregnancy, degenerative atherosclerosis, portal hypertension, medial fibrodysplasia, arteritis, collagen vascular disease, α 1-antitrypsin deficiency, and pancreatitis [2]. Hormonal changes during pregnancy, increased blood volume and cardiac output causing portal congestion are the proposed mechanisms of SAA in pregnancy internal medicine section [5]. SAA are usually single, isolated and <3cms in size. It is usually located in the distal part of splenic artery. Larger aneurysms like in our patient are seldom reported [1,3,6]. The aneurysm generally develops on the main splenic artery commonly on its distal third or on intrasplenic branches. Multiple Splenic Artery Aneurysms: A Rare Cause of Extrahepatic Portal Hypertension and Massive Splenomegaly aBstRaCtA 39-year-old nulliparous female was admitted with massive splenomegaly. Computed tomography of abdomen revealed multiple aneurysms in the distal half of the splenic artery. Splenic artery aneurysms are rare in nulliparous women and most cases are reported in females with a past history of pregnancy. Splenic artery aneurysms, though very...

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Section: Discussionmentioning

confidence: 93%

Multiple Splenic Artery Aneurysms: A Rare Cause of Extrahepatic Portal Hypertension and Massive Splenomegaly

Aroor

Raghuraj

et al. 2014

JCDR

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“…Only 12 cases have been reported so far in English literature. 7) First reported by Beaussier in 1770.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Splenic Arteriovenous Fistula with Giant Venous Aneurysmal Dilatation

Ibrahim

Bassurrah

2012

Annals of Vascular Diseases

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Although splenic artery aneurysm is the commonest visceral and third most common intra abdominal aneurysm after aorta and iliac artery, aneurysm of splenic artery along with aneurysm of splenic vein and arteriovenous fistula is a rare entity. Most of them are <3 cm in diameter. Giant true splenic artery aneurysms are rare and very few lesions >10 cm have been reported. We report a case of 11 cm × 8 cm giant splenic vein aneurysm with splenic arteriovenous fistula as the 1st case of giant splenic venous aneurysm with arteriovenous fistula managed by endovascular treatment.

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“…Más del 95% de los aneurismas detectados durante el embarazo se rompen, lo que conlleva una mortalidad materna del 70% y una mortalidad fetal mayor del 75% [11][12][13] . Aparte de las gestantes, existe otro grupo de pacientes con alto riesgo de ruptura como son los trasplantados hepáticos, por lo que se ha recomendado el estudio de la arteria esplénica previo al trasplante 4 .…”

Section: Discussionunclassified