Unruptured splenic artery aneurysm presenting as epigastric pain

Algudkar, Ashwin

doi:10.1258/shorts.2010.010053

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…Unruptured SAA is usually asymptomatic (over 80%), nevertheless rare symptoms include nausea and vague discomfort in epigastric region5 or left upper quadrant abdominal discomfort with referred left shoulder pain 6. Even rarely, it may be detected incidentally as a pulsatile epigastric mass 7…”

Section: Discussionmentioning

confidence: 99%

Splenic artery aneurysm in a patient of autosomal dominant polycystic kidney disease: beyond tenuous concomitance!

et al. 2019

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Splenic artery aneurysm (SAA) is rare, with risk of rupture especially if diameter is >2 cm. It is usually asymptomatic and detected incidentally on imaging either in young pregnant women or elderly cirrhotic patients. Extracranial vascular abnormalities known to be associated with autosomal dominant polycystic kidney disease (ADPKD) include ascending aortic aneurysms, dissections of coronary and vertebral arteries and rarely SAA. We describe a rare case of incidentally detected SAA in a patient with end stage renal disease due to ADPKD during evaluation of persistent gross haematuria, with no evidence of cranial or other extracranial aneurysms.

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Section: Discussionmentioning

confidence: 99%

Splenic artery aneurysm in a patient of autosomal dominant polycystic kidney disease: beyond tenuous concomitance!

et al. 2019

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“…Symptoms include acute presentation with hypovolaemic shock and acute abdomen secondary to intra-abdominal haemorrhage of rupture. On the other hand, the symptoms of an unruptured aneurysm include epigastric pain,2 such as a left upper quadrant pain referring to the left shoulder, as in this case.…”

Section: Descriptionmentioning

confidence: 94%

Splenic artery aneurysm: pre-rupture diagnosis is life saving

Telfah

2014

BMJ Case Reports

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DESCRIPTIONA 55-year-old woman presented to the outpatient surgical clinic with a history of recurrent attacks of left upper quadrant pain over the last year. Each bout of pain lasted for less than 24 h and was stabbing in nature. The pain interfered with the patient's breathing and affected her left shoulder; it was associated with nausea and, occasionally, vomiting. The patient had a normal appetite, no weight loss and no change in bowel habits. She had received several courses of analgesics and antispasmodics on an assumption of left renal colic and irritable bowel syndrome. She was otherwise healthy with no relevant medical or surgical history. She neither smokes nor consumes alcohol.During the latest attack, the patient developed severe, persistent, mainly upper abdominal pain that referred to the left shoulder, and required hospital admission in the surgical unit for further assessment. On examination, she was pale and overweight (body mass index=29.4). Her pulse was 100/min, regular and of good volume. Blood pressure was 140/70 mm Hg, temperature 37.2°C and respiratory rate 24 breaths/min. Abdominal examination revealed tenderness, guarding and rigidity over the upper abdomen and mainly on the left upper quadrant. There were no palpable masses or organomegaly.A full blood count showed haemoglobin level of 13.1 g/dL, white cell count 11×10 9 /L, platelets 250×10 9 /L and the erythrocyte sedimentation rate was 10 mm/h. General urine examination and serum amylase level were normal. All other laboratory tests were within the normal range. Chest X-ray in erect position showed normal lung fields and no air under the diaphragm. Ultrasound scan showed an ill-defined cystic mass (low echo-texture) at the splenorenal area suggesting a complex cystic mass related to the tail of the pancreas. Contrast-enhanced CT revealed a well-defined oval lesion (41 mm×60 mm) seen at the splenic hilum massively enhancing postcontrast, suggestive of aneurysmal dilation of splenic artery with very thin wall (figure 1). CT angiography confirmed the diagnosis of aneurysm at the distal end of the splenic artery with no thrombus within, and a dilated tortuous splenic artery (figure 2). We were concerned that this might be a case of splenic artery aneurysm (SAA) with impending rupture, which usually explains the clinical presentation of abdominal pain. Informed consent was taken and urgent surgery performed.Laparotomy using an upper abdominal midline incision was performed. There was a tortuous course of splenic artery that ended with a thrilled, fragile, compressible mass at the hilum of spleen with a very thin wall (impending rupture), as shown in figure 3. Proximal vascular control using an arterial clamp (bulldog) was applied at the upper border of the pancreas for secure mobilisation of the spleen and to avoid catastrophic haemorrhaging. A splenectomy was performed together with excision of aneurysmal sac (figure 4). The patient had an uneventful postoperative course and was discharged on the sixth postoperative day. The patient was...

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“…En la actualidad, la vía endovascular cobra un papel protagónico en el manejo de esta patología debido a sus elevadas tasas de éxito y baja morbimortalidad, con buenos resultados en pacientes de cirugía no urgente y candidatos quirúrgicos de riesgo que presentan comorbilidades asociadas o en pacientes con abdomen hostil por pancreatitis, sepsis o cirugías previas. Las principales ventajas de esta técnica son la baja tasa de complicaciones, disminución del dolor postoperatorio, reducción de la estancia hospitalaria, retorno más rápido a las actividades cotidianas y mejor calidad de vida a corto plazo (2,14,22).…”

Section: La Información Incluyeunclassified

“…El aneurisma de la arteria esplénica se define como una dilatación anormal de más del 50 % de diámetro del vaso, es el tercer aneurisma abdominal más frecuente después del aneurisma de la aorta y arterias ilíacas (1,2). Hace parte de los aneurismas de arterias viscerales, con una incidencia del 60 % (3).…”

Section: Introductionunclassified

Aneurisma de arteria esplénica, causa infrecuente de dolor abdominal. Presentación de un caso

Usta

Mendoza

Bustamante

et al. 2020

Rev. colomb. radiol.

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Los aneurismas de las arterias viscerales son relativamente poco frecuentes. El aneurisma de la arteria esplénica es el más común de este grupo, se presenta en el 60 a 70 % de los pacientes. Presentamos el caso de una paciente de 68 años de edad con factores de riesgo cardiovascular, quien consultó por un cuadro de dolor abdominal agudo, intenso, asociado a sensación de peso, y masa pulsátil al examen físico como dato representativo. Mediante angioTAC abdominal y angiografía de tronco celiaco se diagnosticó una dilatación aneurismática sacular en el segmento proximal de la arteria esplénica, la cual, por su localización y con el objetivo de preservar el bazo, fue tratada mediante cateterización selectiva y embolización del saco del aneurisma, para reducir el riesgo de ruptura y lograr un control de síntomas adecuado. A continuación, se explica brevemente la fisiopatología, diagnóstico y los beneficios de la terapia endovascular respecto a otras técnicas.

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Unruptured splenic artery aneurysm presenting as epigastric pain

Cited by 8 publications

References 7 publications

Splenic artery aneurysm in a patient of autosomal dominant polycystic kidney disease: beyond tenuous concomitance!

Splenic artery aneurysm in a patient of autosomal dominant polycystic kidney disease: beyond tenuous concomitance!

Splenic artery aneurysm: pre-rupture diagnosis is life saving

Aneurisma de arteria esplénica, causa infrecuente de dolor abdominal. Presentación de un caso

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