Spontaneous ruptured splenic artery aneurysm: a case report

Abstract

Splenic artery aneurysms are rare. We discuss a case of a 58-year-old gentleman presenting with collapse and shock secondary to spontaneous splenic artery aneurysm rupture. Patient underwent laparotomy and splenectomy then discharged home within a week of presentation.

Spontaneous rupture of the splenic artery aneurysm: a rare clinical presentation of acute abdomen.

“…In pregnant women, compression of the aorta by the uterus is believed to increase portal congestion and increased hormone levels, estrogen and relaxin, lead to vascular intimal hyperplasia and fragmentation of the internal elastic membrane. [3][4][5] The rupture of SAA may result in exsanguinating hemorrhage and the reported rate of rupture is between 3% and 9.6%, and about 10% of SAAs are ruptured at the time of diagnosis with a reported mortality rate of 36-75%. [3,5] Rupture and bleeding result in sudden abdominal pain and even in rapidly progressing hypovolemic shock; as it wasthe case presented here.…”

Management of Spontaneously Ruptured Splenic Artery Aneurysm in Pregnancy with Endovascular Stent-Graft

“…The risk of fetal loss can exceed 90% [18,19]. In pregnancy, rupture tends to occur more frequently during the third trimester perhaps secondary to a more hypertensive picture [20]. In about 20% to 25% of cases, the aneurysm first ruptures into the lesser sac where it is tamponaded by a blood clot at the foramen of Winslow.…”

“…Emergent surgical or endovascular intervention is the treatment of choice for patients with ruptured SAA. Laparotomy and aneurosectomy with or without splenectomy has been the mainstay approach to management [12,20,24]. Recently, laparoscopic and endovascular modalities have also been introduced [5,20].…”

“…Laparotomy and aneurosectomy with or without splenectomy has been the mainstay approach to management [12,20,24]. Recently, laparoscopic and endovascular modalities have also been introduced [5,20]. While successful endovascular embolization has been reported for ruptured SAA, endovascular stent-graft placement has been mostly studied in the elective setting [1,[25][26][27].…”

Imaging sketch of bedside ultrasonography to improve the diagnosis of rupture of splenic artery aneurysm

“…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.…”