Case Report: Secondary Rupture of a Splenic Artery Pseudoaneurysm

Abstract

The rupture of arterial aneurysm of digestive origin remains a rare pathology in general, but it is always a crisis situation that must be taken care of quickly because the vital prognosis is constantly engaged. It is necessary to be aware of the fact that this pathology requires a rapid therapeutic management with a significant reactivity and that the treatment passes at the same time by the precocity of the recognition of the diagnosis, the speed of initiation of resuscitation maneuvers and finally the repair by surgery. Splenic artery aneurysms are usually asymptomatic, and discovered incidentally on imaging, or by their rupture. The state of hemorrhagic shock is the most frequent mode of revelation (90%), with cardiovascular collapse and inconstantly digestive hemorrhage. The injected abdominal CT scan is the reference examination. It is carried out in search of hemoperitoneum, active bleeding, and in search of the false aneurysm responsible for the bleeding. Surgery, until very recently, was the only therapeutic alternative. Interventional vascular radiology represents a particularly interesting alternative to surgery alone, especially in fragile subjects. It nevertheless remains a delicate technique due to the morphology and the very location of the aneurysms.