Splenic Artery Aneurysm Presenting as Extrahepatic Portal Vein Obstruction: A Case Report

T P Elamurugan,S Suresh Kumar,Vikram Kate,R Muthukumarassamy

doi:10.1155/2011/908529

Abstract

Splenic artery aneurysms are the most common visceral aneurysm occuring predominantly in females. They are usually asymptomatic, and the symptomatic presentation includes chronic abdominal pain of varied severity or an acute rupture with hypotension. Splenic artery aneurysm causing extrahepatic portal hypertension is very rare and is due to splenic vein thrombosis that develops secondary to compression by the aneurysm. We report one such rare presentation of splenic artery aneurysms in a pregnant female with the features of EHPVO (variceal bleed, hypersplenism) treated by splenectomy along with excision of the aneurysm.

Highlights

Splenic artery aneurysms (SAAs) are the most common visceral aneurysm accounting for up to 60% in the reported series [1]
The incidence of splenic artery aneurysm is 0.01–0.2%, occuring more commonly in females especially during pregnancy with a female to male ratio of 4 : 1. Up to 80% of the SAA are detected in asymptomatic patients on routine evaluation for other problems [1]
We report an unusual presentation of splenic artery aneurysm causing extrahepatic portal venous obstruction (EHPVO) and presenting with upper gastrointestinal bleed and hypersplenism

Summary

Introduction

Splenic artery aneurysms (SAAs) are the most common visceral aneurysm accounting for up to 60% in the reported series [1]. Atypical presentation of the SAA reported in literature includes acute massive upper gastrointestinal bleed due to rupture of aneurysm in to the stomach or pancreas and lower gastrointestinal bleeding due to rupture in to the colon [2,3,4]. SAA causing EHPVO and presenting with features of portal hypertension is extremely rare, Only few cases have been reported in the literature [5,6,7]. We report an unusual presentation of splenic artery aneurysm causing extrahepatic portal venous obstruction (EHPVO) and presenting with upper gastrointestinal bleed and hypersplenism

Case Report

Discussion

Findings

Conclusion