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Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 487-489
Splenic artery aneurysm


Smt. Scl Muni. Hospital, Smt.Nhl Muni.Medical College, Department Of Radiology, Saraspur, Ahmedabad, India

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Date of Submission24-Feb-2006
Date of Acceptance08-Aug-2006
 

How to cite this article:
Gandhi V S, Thakkar G N, Rajput D K, Rajvaidya N P. Splenic artery aneurysm. Indian J Radiol Imaging 2006;16:487-9

How to cite this URL:
Gandhi V S, Thakkar G N, Rajput D K, Rajvaidya N P. Splenic artery aneurysm. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Aug 24];16:487-9. Available from: http://www.ijri.org/text.asp?2006/16/4/487/32252

   Introduction Top


Most common of all visceral aneurysms. Third most common of all intra-abdominal aneurysms and more common in females with 4: 1 predominance.

This rare condition has known worldwide incidence of 0.4 to 1% on autopsy.

Here, in this report, we describe diagnosis of splenic artery aneurysm, in 50 years old female patient; which was as such an incidental finding. Patient was known diabetic on anti-diabetic drugs for past 4 years.

Physical findings and laboratory reports were insignificant.


   Radiolocial findings Top


A plain X-Ray abdomen erect was obtained, which was normal.

USG abdomen was performed which showed anechoic cystic lesion in the relation to tail of pancreas. Calcification was seen in wall of artery, at the level of aneurysm. Pancreas appeared normal in size and echo texture. Main pancreatic duct was measured 2mm.The rest of the abdomen was normal.

On Color Doppler study, complete filling of color, in the lesion was seen. Pulse wave study confirmed the arterial flow pattern. (Initial scan in B-mode reported it to be a pancreatic pseudocyst!)

CT scan showed well-defined isodense lesion with calcification in region of splenic hilum.

On contrast study, there was intense homogenous enhancement was seen in the lesion, which measured 5.3 x 3.8 cm in size. The lesion was arising in the distal part of the splenic artery.

A splenectomy was performed with the length of artery including the aneurysm was removed.


   Discussion Top


This uncommon condition is predisposed in women, probably due to increased blood flow in pregnancy. Etiologically, medial degeneration with superimposed atherosclerosis & other causes are congenital, pancreatitis, trauma, portal hypertension. May be associated with fibro muscular disease.

The size of the SAA varies from less than 2cm, which are commonest, but sizes up to 10 cm have been reported. In 20% cases multiple aneurysms are present. Most splenic artery aneurysms occur at bifurcation of distal splenic artery.

Usually asymptomatic, unless it ruptures but may present as left sided pain with GI bleeding.

Physically, it may present as a soft palpable lesion in epigastrium or left lumbar region.

Rupture occurs mostly in lesser sac, progressing into free intraperitoneal hemorrhage, through foramen of winslow.

Generally, it is an accidental finding on plain X ray of abdomen, a calcified curvilinear lesion may be seen because intra/extra splenic calcified wall of aneurysm.

Though USG is always the initial investigation on which diagnosis can be made, CT scan is very helpful for location and size of lesion and for operative management. Diagnosis on CT Scan is made on the basis of intense enhancement of the well-circumscribed lesion, which is in communication to the artery. Though selective celiac arteriography provides the confirmatory diagnosis, the CT angiography is faster becoming the modality of choice for intra-abdominal aneurysms.

The rupture of aneurysm is unsuspected in about half of cases, which presents as splenic rupture.

The treatment is splenectomy and removal of length of artery bearing the aneurysm. If the aneurysm, presents in the proximal splenic artery near origin, usually the proximal and distal ligation of the sac is usually followed by the thrombosis in the aneurysm. In young women, with asymptomatic splenic artery aneurysm, surgical treatment is indicated after confirmation of diagnosis[5].

 
   References Top

1.Dahnert Radiology Review Manual 4th Edition Heart&Great Vessel, 1692.  Back to cited text no. 1    
2.Bailey &Love's Short Practise Of Surgery 23rd Edition; he Spleen; 53, 956.  Back to cited text no. 2    
3.Sabiston Text Book Of Surgery 16th Edition; Vascular And Visceral Artery Aneurysm; Section 12, 2209.  Back to cited text no. 3    
4.Schwartz Principle Of Surgery 7th Edition; Abdominal Wall, Omentum,Mesentery And Retroperitonium;33,38.  Back to cited text no. 4    
5.washington Manual Of Surgery 2002; Aneurysmal Arterial Disease;23,30.  Back to cited text no. 5    

Top
Correspondence Address:
V S Gandhi
Smt. Scl Muni. Hospital, Smt.Nhl Muni.Medical College, Department of Radiology, Saraspur, Ahmedabad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32252

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7]



 

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    Introduction
    Radiolocial findings
    Discussion
    References
    Article Figures

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