Imaging Investigation of a Giant Splenic Artery Aneurysm

Vlychou, Marianna; Kokkinis, Constantinos; Stathopoulou, Sotiria; Tsilikas, Constantinos; Λαζούρα, Όλγα; Petinelli, Adamantia; Papadaki, Paraskevi J.; Fezoulidis, Ioannis

doi:10.1177/0003319707305345

Cited by 13 publications

(10 citation statements)

References 7 publications

(17 reference statements)

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“…The incidence of SAA among patients with a diagnosis of cirrhosis and portal hypertension varies from 7 to 50%, and PHT is diagnosed in 50% of SAA patients. 3 , 18 , 33 Hormonal changes during pregnancy and increased splenic artery outflow might contribute to either the improvement of a new aneurysm, enlargement of a preexisting lesion, or rupture of an aneurysm. 7 , 14 , 18 The third trimester of pregnancy is the period with the highest risk.…”

Section: Discussionmentioning

confidence: 99%

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%

Management of Giant Splenic Artery Aneurysm

2015

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“…In addition, an intraperitoneal hematoma filling the gap between the spleen and stomach can also be seen. arterial aneurysms, and Vlychou et al [1] found that they had an incidence rate of between 0.02 and 2% in a large autopsy series that included all age groups. Moreover, the third most common abdominal aneurysm is an SAA.…”

Section: Discussionmentioning

confidence: 98%

“…Splenic artery aneurysms (SAAs) are relatively rare, even though they are the most common of the visceral aneurysms and the third most common intraabdominal aneurysms after aortic and iliac. [1,2] They may result from a congenital weakness of the arterial wall, pregnancy, portal hypertension (HT), or atherosclerosis. [3] The great majority of SAAs are asymptomatic and are diagnosed incidentally on imaging studies.…”

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confidence: 99%

Spontaneous rupture of an isolated splenic artery aneurysm: an unusual cause of an acute abdomen

Tıhan¹

2015

Turk Gogus Kalp Dama

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Hipertansiyon öyküsü olan 65 yaşındaki kadın hasta yaygın karın ağrısı ile hastaneye başvurdu. Fizik muayenede akut karın bulguları saptandı. Abdominal ultrasonografide karın içerisinde serbest sıvı görüldü ve bilgisayarlı tomografide izole bir splenik arter anevrizması saptandı. Laparotomi, splenik arter ligasyonu, splenektomi ve kolesistektomi yapıldı. Literatürde izole splenik arter anevrizmasının spontan rüptürüne ilişkin olgu sunumları nadirdir. Bu yazıda, alışılmışın dışında bir akut karın nedeni sunuldu.

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“…SAA is a rare pathology with an incidence estimated at 0.01% in the general population with incidence at autopsy shown to be 0.2%–2% 1. Above the age of 60 years this incidence has been shown to increase to 10% in general, with figures approaching 50% in patients with portal hypertension 1 2. True aneurysms are usually asymptomatic, in contrast to pseudoaneurysm which have a reported rate of rupture of 37%–47%, with devastating consequences 3–5.…”

Section: Introductionmentioning

confidence: 99%

Splenic artery aneurysm as a rare cause of an upper GIT bleed

2019

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Upper gastrointestinal bleeding (UGIB) is a common life-threatening presentation in the emergency department. Causes are typically divided into variceal and non-variceal bleeds. Non-variceal pathologies typically include bleeding peptic ulcers, haemorrhagic gastritis and Mallory Weiss Tears. Occassionally, less common pathologies are encountered such as Dieulafoy’s lesions, haemosuccus pancreas, haemobilia or aorto-enteric fistula. The following report documents the case of a 49-year-old man who presented with an UGIB. His risk factors included a history of nonsteroidal anti-inflammatory drug, smoking and ethanol abuse. Despite his typical presentation and risk factors, investigation revealed an unusual and rare pathology. He was found to have a giant splenic artery aneurysm, abutting and eroding the gastric mucosa. Diagnosis was made using a combination of gastro-oesophagoscopy and CT scan. Successful treatment consisted of angio-embolisation of the aneurysm.

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Imaging Investigation of a Giant Splenic Artery Aneurysm

Cited by 13 publications

References 7 publications

Management of Giant Splenic Artery Aneurysm

Management of Giant Splenic Artery Aneurysm

Spontaneous rupture of an isolated splenic artery aneurysm: an unusual cause of an acute abdomen

Splenic artery aneurysm as a rare cause of an upper GIT bleed

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