Ruptured spontaneous splenic artery aneurysm: A case report and review of the literature

Abdulrahman, Aisha; Shabkah, Alaa A; Hassanain, Mazen; Aljiffry, Murad

doi:10.1016/j.ijscr.2014.08.021

Cited by 45 publications

(56 citation statements)

References 22 publications

(17 reference statements)

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“…But, most patients with significant pain experiencing rupture of acute expansion SAAs that have ruptured or are symptomatic require urgent treatment (9). The risk of rupture is about 2 to 10% for small and 28% for giant aneurysms in low risk individuals during their lives (10). Immediate definite therapy is crucial for symptomatic and bigger than 2 cm aneurysms once the diagnosis is made (11).…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy for Splenic Artery Aneurysm: A Case Report

Alamdari

Massoudi

Asgarpour

2017

Iran Red Crescent Med J

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Introduction: Splenic artery aneurysms are the most common visceral arterial aneurysm formations, as well as the 3rd frequent abdominal aneurysm. Most of them are asymptomatic until rupture and are ascertained unintentionally, usually after an imaging study. Open surgery is the elective therapy for splenic artery aneurysm, but has the disadvantages of severe surgical injuries including high rates of mortality and high risk complications. Case Presentation: In this case report, we present a 44-year-old woman with right upper quadrant abdominal pain diagnosed as Splenic artery aneurysms. This pain was first vague and gradually caused more discomfort and, occasionally, caused a sharp pain with radiation to the back that had no relation with food or position aneurysms. Conclusions: Selection of a suitable super-stiff guide wire during the procedure to provide sufficient support and decrease the difficulties related to stent graft delivery and release seems to be necessary. Nowadays endovascular modality for the treatment of splenic artery aneurysm is recognized and in selected patients can be done with fewer complications and good results.

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Section: Discussionmentioning

confidence: 99%

Endovascular Therapy for Splenic Artery Aneurysm: A Case Report

Alamdari

Massoudi

Asgarpour

2017

Iran Red Crescent Med J

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“…Splenic artery aneurysm is a rare condition with a prevalence of less than 1% in the general population and is more common in women; however, it is the third most common cause of intra-abdominal aneurysms and the most common among visceral arterial aneurysms 1 . This condition was first described by Beussier in 1770; some of the risk factors often described are: fibrodysplasia, portal hypertension, splenomegaly, cirrhosis of the liver, liver transplant, pancreatitis, vasculitis, infectious mononucleosis, and pregnancy [1][2][3][4][5][6] .…”

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confidence: 99%

“…This condition was first described by Beussier in 1770; some of the risk factors often described are: fibrodysplasia, portal hypertension, splenomegaly, cirrhosis of the liver, liver transplant, pancreatitis, vasculitis, infectious mononucleosis, and pregnancy [1][2][3][4][5][6] . Pregnancy is considered the most important risk factor for the rupture of this aneurysm, but the true prevalence of this event is unknown 2 .…”

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Spleen rupture during labor

Bessow¹,

Balbinotto²,

Müller³

et al. 2016

cbr

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Splenic artery aneurysm is a rare condition with a prevalence of less than 1% in the general population and is more common in women; however, it is the third most common cause of intra-abdominal aneurysms and the most common among visceral arterial aneurysms 1 . This condition was first described by Beussier in 1770; some of the risk factors often described are: fibrodysplasia, portal hypertension, splenomegaly, cirrhosis of the liver, liver transplant, pancreatitis, vasculitis, infectious mononucleosis, and pregnancy [1][2][3][4][5][6] . Pregnancy is considered the most important risk factor for the rupture of this aneurysm, but the true prevalence of this event is unknown 2 . Increased splanchnic and splenic circulation during pregnancy has been indicated as one of the main factors in the development of aneurysms. The modifications in circulation induced by estrogen and progesterone during pregnancy may also contribute to weakening blood vessel walls, especially at the bifurcations. It is speculated that the greater the woman's parity the greater the risk of development and rupture of the aneurysm, due to the successive stresses to which the vessel wall is submitted 3 . The importance of an adequate diagnosis and management of this condition, despite its low prevalence, is supported by the high rates of maternal and fetal mortality, 75 and 95%, respectively 3 . CLINICAL CASEA 38-year-old pregnant woman with 41 weeks of gestational age and two previous vaginal deliveries without complications or known comorbidities was admitted to the obstetrical center of Hospital de Clínicas de Porto Alegre and treated according to a protocol for post-term pregnancy.At admission, the patient had a cervical dilation of 2 cm and weak uterine contractions, and cardiac-fetal heart rate was normal. After using intravenous oxytocin for 2 hours, in an infusion pump at a concentration of 10 mU/min, she presented a dynamic of three contractions in 10 min and was 5 cm dilated. Two hours later, during non-pharmacological approaches to relieve pain (bath in labor), she presented with strong abdominal pain, dyspnea, dizziness, and paleness. The medical team was called for assessment. At vaginal palpation amniorrhexis and complete cervical dilation were diagnosed, and the patient was sent to the delivery room in the expulsion stage.In the delivery room her dyspnea, respiratory effort, and hypotension became worse. She was submitted to orotracheal intubation and invasive measurement of arterial pressure by the anesthesia team, and volemic replacement was started. The delivery was performed with a left mediolateral episiotomy and fetal extraction with Simpson's forceps. A female baby was born weighing 3705 g and with Apgar scores of 2/6/9 in the 1st, 3rd and 5th minutes, respectively, and sent directly to the care of the Neonatal Unit. Umbilical cord blood gas showed a fetal pH of 6.9. Immediately after delivery, the rapid response team (RRT) was called and the patient was sent to the intensive care unit (ICU) on mechanical ventilation. A be...

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“…2 The diagnosis of this disease is clinically difficult without imaging. [3][4][5][6] Due to rarity of this disease, we considered noteworthy to report the imaging, which lies to a diagnosis of SAA in a 58-year-old woman who was admitted to Emergency Room for the rapid onset of epigastric pain, not associated with other symptoms. She was previously cholecystectomized for gallstones and she did not take any medication.…”

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confidence: 99%

“…Emergency surgical management may improve survival of these kinds of patients. 5 An alternative approach to SAA is endovascular treatment that should be preferred for those patients unfit for surgery or those who may be treated in elective settings. 5,9 Nevertheless, a correct diagnosis, especially using bedside ultrasonography, significantly improves the correct management of patients having SAA in Emergency Room.…”

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confidence: 99%