Management of the Splenic Artery Aneurysm: with a Six Different Clinical Presentation and Treatment Modality

Abstract

Splenic artery aneurysm is the enlargement of the splenic artery more than 1 cm and can be a life-threatening condition. Trauma, pregnancy, portal hypertension, atherosclerosis, advanced age, and female gender are underlying risk factors. Although the patients are mostly asymptomatic, the symptoms may range from pain in the epigastrium, left upper quadrant, to sudden onset of severe abdominal pain and shock as a result of rupture. In our study, the data of six splenic artery aneurysm patients who applied to Istanbul University Cerrahpasa, Cerrahpasa Medical Faculty General Surgery Clinic, between 2015 and 2019 with different clinical presentations and treated with different methods were retrospectively analyzed. Six patients with splenic artery aneurysm were reviewed. They were 4 women and 2 men aged 28 to 66 years. The mean diameter of aneurysms was 4.42 cm and the average hospitalization duration was 6.8 days. All patients presented with abdominal pain. Two patients had also low hemoglobin value and hypovolemic shock due to intraabdominal bleeding. Splenic artery aneurysm rupture was diagnosed in 1 patient who was 28 weeks of gestation. Only aneurysmectomy was performed on 2 patients, aneurysmectomy + splenectomy on 3, and coil embolization on 1. Since splenic artery aneurysm may present with different clinical signs and may have high mortality due to the risk of rupture, it can be safely treated by using different modalities according to the patient's specifications after the appropriate and early diagnosis.