Sudden death due to spontaneous rupture in splenic artery atypical dissection with features of vasculitis: Case report and review of the literature

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

“…Rheumatologic disorders may be associated with vasculitis and several reported cases are associated with aneurysmatic splenic artery developed with vasculitic involvement. [7,8] It is unusual for sarcoidosis to involve vessels but splenic involvement may occur as the presented case revealed non-caseating granuloma formation within the spleen and in the splenic hilus consistent with sarcoidosis but not in the vessel wall per se. [9] Consent: Written informed consent was obtained from the patientfor publication of this case report and accompanying images.…”

“…[3,5] Rupture and bleeding result in sudden abdominal pain and even in rapidly progressing hypovolemic shock; as it wasthe case presented here. [6,7] In fact, SAA is a rare diagnosis in the emergency department with a prevalence of approximately 0.011%. [1] They are usually small but aneursyms as large as 30 cm have been reported.…”

Vascular, Cardiac Valve, and Metabolic Diseases

“…These inflammatory infiltrates are often encountered only focally and need to be distinguished from primary inflammatory vascular disease, which could itself be the cause of the aneurysm. Unusual localizations of aneurysms have also been described in the recent forensic literature (Desinan et al 2010;Kodikara and Sivasubramanium 2009). In some cases, histological investigations can reveal, e.g., vasculitis or fibromuscular dysplasia as the cause of (dissecting) aneurysm or provide evidence of thrombosis and fungal colonization (Ortmann et al 2010;Hagemeier et al 2009).…”

“…Aortic dissection is defined as follows: penetration of blood into the vessel wall through a tear in the intima, forming a split between coats or medial laminae that may be complicated by rupture; it is due to degeneration of connective or elastic fibers of the media and the main predisposing factors include: hypertension, Marfan syndrome, idiopathic cystic medial necrosis, pregnancy, some congenital cardiovascular diseases, as well as damage due to arterial catheterization or aortic valve surgery (Desinan et al 2010;Dermengiu et al 2009). In individual cases, consideration should be given to whether aortic dissection could have occurred in the setting of resuscitation measures (Patterson et al 1974;Nelson and Ashley 1965).…”

“…Macroscopi cally detectable anomalies in coronary arteries in particular are also rare (Schmitt 1973). In contrast, arterio sclerotic aneurysms are unproblematic; however, their distinction from primary vasculitides is occasion ally challenging (Desinan et al 2010, Dettmeyer et al 1998a.…”