Splenic Artery Aneurysm Presenting Research Articles

Spontaneous rupture of a large splenic artery aneurysm in a 59-year-old male patient with pemphigus vulgaris: a case report

BackgroundThere is currently no information on the anatomical risk factors for splenic artery aneurysm rupture, specifically the location or size of the lesion; therefore, reporting this entity to obtain data and ultimately reduce morbidity and mortality is essential. Here we report a case of a male patient with spontaneous rupture of a large splenic artery aneurysm presenting with abdominal pain.Case presentationA 59-year middle-eastern male, with known pemphigus vulgaris presented with a chief complaint of headache and syncope, followed by abdominal pain along with severe metabolic acidosis. A contrast-enhanced computed tomography scan of the abdomen and pelvic showed a splenic artery aneurysm of 33 × 30 mm with a 150 × 90 mm hematoma formation around the aneurysm site. The patient underwent an operation and splenectomy, with confirmation of the diagnosis of ruptured splenic artery aneurysm.ConclusionIt is essential to consider splenic aneurysm rupture as a second-line differential diagnosis, especially among patients with comorbid diseases, as this can lead to timely and appropriate lifesaving intervention.

S2347 Spontaneous Ruptured Splenic Artery Aneurysm Presenting as an Acute Abdominal Mass

S2347 Spontaneous Ruptured Splenic Artery Aneurysm Presenting as an Acute Abdominal Mass

Giant splenic artery aneurysm presenting with massive upper gastrointestinal bleeding: A case report and review of literature

BACKGROUNDSplenic artery aneurysm (SAA) and pseudoaneurysm are rare vessel’s lesions. Pseudoaneurysm is often symptomatic and secondary to pancreatitis or trauma. True SAA is the most common aneurysm of visceral vessels. In contrast to pseudoaneurysm, SAA is usually asymptomatic until the rupture, with high mortality rate. The clinical onset of SSA’s rupture is a massive life-threatening bleeding with hemodynamic instability, usually into the free peritoneal space and more rarely into the gastrointestinal tract.CASE SUMMARYWe describe the case of a 35-year-old male patient, with negative past medical history, who presented to the emergency department for massive upper gastrointestinal bleeding, severe anemia and hypotension. An esophagogastroduodenoscopy performed in emergency showed a gastric bulging in the greater curvature/posterior wall with a small erosion on its surface, with a visible vessel, but no active bleeding. Endoscopic injection therapy with cyanoacrylate glue was performed. Urgent contrast-enhanced computed tomography was carried out due to the clinical scenario and the unclear endoscopic aspect: The radiological examination showed a giant SAA which was adherent to posterior stomach wall, and some smaller aneurysms of the left gastric and ileocolic artery. Because of the high risk of a two-stage rupture of the giant SAA with dramatic outcome, the patient underwent immediate open surgery with aneurysmectomy, splenectomy and distal pancreatectomy with a good postoperative outcome.CONCLUSIONThe management of a ruptured giant SAA into the stomach can be successful with surgical approach.

A Unique Presentation of Splenic Artery Aneurysm During Pregnancy

Visceral arterial (VAA) and, specifically, splenic arterial aneurysms (SAA) are rare entities often associated with pregnancy. When ruptured, they can be fatal and require emergent management. This case report includes a review of the relevant literature and describes a unique, multidisciplinary approach to managing such an aneurysm. We describe the difficult situation of an already rupturing aneurysm and the careful coordination of obstetric, surgical, vascular, and interventional radiology teams. The distinctiveness of this case continues with the intraoperative finding of metallic coils freely protruding into the peritoneum from a recently coil-embolized ruptured splenic artery aneurysm. Such iatrogenic foreign bodies are a product of the integration of multiple specialities that can provide life-saving care when managing critical surgical disease such as ruptured splenic artery aneurysms. Multidisciplinary approaches should be considered depending upon the resources available at one’s institution.

A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report

BackgroundSplenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding.Case presentationA 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable. A third upper gastrointestinal endoscopy detected a pulsatile bulge at the posterior wall of the gastric antrum. A contrast-enhanced computed tomogram of his abdomen detected a splenic artery aneurysm measuring 3 × 3 × 2.5 cm. While awaiting routine surgery, he developed a torrential upper gastrointestinal bleeding and shock, leading to emergency laparotomy. Splenectomy and en bloc resection of the aneurysm with the posterior stomach wall were performed. Histology revealed evidence for a true aneurysm without overt, acute, or chronic inflammation of the surrounding gastric mucosa. He became completely asymptomatic 2 weeks after the surgery.ConclusionsSplenic artery aneurysms can result in recurrent upper gastrointestinal bleeding. The possibility of impending catastrophic bleeding should be remembered when managing patients with splenic artery aneurysms after a minor bleeding. Negative endoscopy and ultrasonography should require contrast-enhanced computed tomography to look for the cause of recurrent upper gastrointestinal bleeding.

腹部大動脈瘤術後遠隔期の下血と貧血の精査中に判明した小径脾動脈瘤の膵管内破裂に対する1治験例

腹部大動脈瘤術後遠隔期の下血と貧血の精査中に判明した小径脾動脈瘤の膵管内破裂に対する1治験例

Splenic artery aneurysm presenting with clinical features of a bleeding gastric gastrointestinal stromal tumour.

Gastrointestinal stromal tumours often present with insidious upper gastrointestinal symptoms. Initial definitive diagnosis can be difficult and therefore misdiagnosis is not infrequent. Here we report a case of upper GI bleeding caused by a splenic artery aneurysm that was misdiagnosed as a gastric GIST. This rare presentation of splenic artery aneurysm highlights the potential pitfalls of investigation in upper gastrointestinal disease.

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

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.

Unruptured splenic artery aneurysm presenting as epigastric pain

We present the case of a patient who presented to the surgical department with a symptomatic unruptured splenic artery aneurysm.

MASSIVE UPPER GASTROINTESTINAL HAEMORRHAGE DUE TO INTRAGASTRIC RUPTURE OF A SPLENIC ARTERY ANEURYSM

SUMMARYMost cases of splenic artery aneurysm are asymptomatic, being found incidentally at the time of investigations (e.g. ultrasound, computed tomography, angiography) or laparotomy for other conditions. Rupture of a splenic artery aneurysm with erosion into the stomach is a rare cause of massive upper gastrointestinal haemorrhage. This case report is, to our knowledge, only the second case of splenic artery aneurysm presenting with massive upper gastrointestinal haemorrhage due to erosion into the stomach in a nulliparous woman.

Splenic artery aneurysm presenting as left renal mass

A case of splenic artery aneurysm presenting as a left upper quadrant mass represents a diagnostic challenge due to its paucity of clinical signs and symptoms. The condition must be distinguished from urologic pathology. Celiac angiography is necessary for diagnostic confirmation. Surgical resection is advised for most patients.