Intragastric rupture of a splenic artery aneurysm - a case report

Abstract

IntroductionHematemesis caused by intragastric rupture of a splenic artery aneurysm, is an exceptional and potentially lethal emergency.Case presentationA 36 years old woman, mother of seven children presented with hematemesis. The gastric endoscopy revealed a bleeding polypoid lesion leading to a surgical management. The operative discovery of a complicated splenic artery aneurysm, led to its resection with splenectomy and gastric suture.ConclusionIntragastric rupture of a splenic artery aneurysm is an exceptional emergency which urgent diagnosis and management can avoid a potential lethal evolution.

Double Catheter Technique: A New Approach for Treatment of Anatomically Challenging Splenic Artery Aneurysm : A Case Report

“…The splenic artery aneurysm is more common in female (1,5,8) due to the increased blood flow to the splenic artery, and the elevated level of hormones (oestrogen, progesterone, relaxine) during pregnancy. (1,5) The majority of these aneurysms are single, ≤ 2cm in size, and located in the mid to distal third of the splenic artery.…”

“…The splenic artery aneurysm is more common in female (1,5,8) due to the increased blood flow to the splenic artery, and the elevated level of hormones (oestrogen, progesterone, relaxine) during pregnancy. (1,5) The majority of these aneurysms are single, ≤ 2cm in size, and located in the mid to distal third of the splenic artery. (5,9) The most commonly encountered complication for these aneurysms is rupture, mostly into the peritoneal cavity, and less likely into the stomach, colon, or pancreas.…”

“…(5,9) The most commonly encountered complication for these aneurysms is rupture, mostly into the peritoneal cavity, and less likely into the stomach, colon, or pancreas. (1,8) The risk of rupture varies from 2-9.6%. (6) The mortality rate following rupture is high, reaching up to 25%.…”

“…(6) The mortality rate following rupture is high, reaching up to 25%. (1) Treatment should be offered to patients with symptomatic aneurysms, large aneurysms (>2cm), growing aneurysms on follow-up, and women of childbearing age. (10) In our case, the indication for treatment was the size of the aneurysm, and the presence of symptoms.…”

“…(1)(2)(3)(4) As for the intra-abdominal aneurysms, the splenic artery is the third most common site for aneurysm formation after the aorta, and the iliac arteries. (1)(2)(3) The majority of these aneurysms are asymptomatic, (5)(6)(7) and are discovered incidentally on imaging. Other presentations include chronic abdominal pain or hemorrhagic shock presenting with hypotension following acute rupture in the peritoneal cavity.…”