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

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World Journal of Gastroenterology 2020年第22期26卷 3110-3117页

作者： Francesco Panzera Riccardo Inchingolo Marina Rizzi Assunta Biscaglia Maria Grazia Schievenin Emilia Tallarico Giancarlo Pacifico Beatrice Di Venere Division of Gastroenterology Department of SurgeryMadonna delle Grazie HospitalMatera 75100Italy Division of Interventional Radiology Department of RadiologyMadonna delle Grazie HospitalMatera 75100Italy Department of Intensive Care Madonna delle Grazie HospitalMatera 75100Italy Department of Pathology Madonna delle Grazie HospitalMatera 75100Italy Division of General Surgery Department of SurgeryMadonna delle Grazie HospitalMatera 75100Italy

BACKGROUND splenic artery aneurysm(SAA)and pseudoaneurysm are rare vessel’s *** is often symptomatic and secondary to pancreatitis or *** SAA is the most common aneurysm of visceral *** contrast to pseudoaneurysm,SAA is usually asymptomatic until the rupture,with high mortality *** 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 *** SUMMARY We 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 *** 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 *** injection therapy with cyanoacrylate glue was *** 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 *** 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 *** The management of a ruptured giant SAA into the stomach can be successful with surgical approach.

关键词： splenic artery aneurysm Upper gastrointestinal bleeding Hemorrhagic shock Computed tomography Endoscopy Case report

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Management of splenic artery aneurysm associated with extrahepatic portal vein obstruction

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 330-333页

作者： Pramod Kumar Mishra Sundeep Singh Saluja Ashok K Sharma Premanand Pattnaik Department of Gastrointestinal Surgery Surgery GB Pant Hospital Department of Gastrointestinal Surgery and Department of Radiology Surgery GB Pant Hospital Department of Gastrointestinal Surgery GB Pant Hospital

BACKGROUND: splenic artery aneurysms although rare are clinically significant in view of their propensity for spontaneous rupture and life-threatening bleeding. While portal hypertension is an important etiological factor, the majority of reported cases are secondary to cirrhosis of the liver. We report three cases of splenic artery aneurysms associated with extrahepatic portal vein obstruction and discuss their management. METHODS: The records of three patients of splenic artery aneurysm associated with extrahepatic portal vein obstruction managed from 2003 to 2010 were reviewed retrospectively. The clinical presentation, surgical treatment and outcome were analyzed. RESULTS: The aneurysm was >3 cm in all patients. The clinical symptoms were secondary to extrahepatic portal vein obstruction (hematemesis in two, portal biliopathy in two) while the aneurysm was asymptomatic. Doppler ultrasound demonstrated aneurysms in all patients. A proximal splenorenal shunt was performed in two patients with excision of the aneurysm in one patient and ligation of the aneurysm in another one. The third patient had the splenic vein replaced by collaterals and hence underwent splenectomy with aneurysmectomy. All patients had an uneventful post-operative course. CONCLUSIONS: splenic artery aneurysms are associated with extrahepatic portal vein obstruction. Surgery is the mainstay of treatment. Although technically difficult, it can be safely performed in an experienced center with minimal morbidity and good outcome.

关键词： splenic artery aneurysm extrahepatic portal vein obstruction portal hypertension proximal splenorenal shunt

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Computed Tomography Angiography in Diagnosis and Treatment of splenic artery aneurysm

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Chinese Medical Journal 2016年第3期129卷 367-369页

作者： Chun-Xi Wang Shu-Li GUO Li-Na Han Yang Jie Hai-Di Hu Jing-Ru Cheng Miao Yu Yue-Yong Xiao Tai Yin Fu-Tao Chu Fa-Qi Liang Department of General Surgery Chinese PLA General Hospital Beijing 100853 China State Key Laboratory of Intelligent Control and Decision School of Automation Beijing Institute of Technology Beijing 100081 China Department of Cardiovascular Internal Medicine Nanlou Branch of Chinese PLA General Hospital Beijing 100853 China Department of CT Radioactive Intervention Chinese PLA General Hospital Beijing 100853 China Department of Vascular Surgery First Clinical Hospital of China Medical University Shenyang 110001 China

splenic artery aneurysm, without obvious symptoms, is a direct threat to the patient＇s life, once it ruptures as hemorrhagic *** examinations have been the main diagnostic methods of splenic artery aneurysm, including ultrasound, computed tomography （CT）, magnetic resonance imaging, and digital subtraction angiography （DSA）.Although various inspective methods have their own advantages and disadvantages, abdominal CT examination is the most comprehensively applied method in clinical *** representative images of splenic artery aneurysm from a relatively large number of patients examined by CT are presented in this study.

关键词： aneurysm Resection Computed Tomography Angiography splenic artery aneurysm

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splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

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World Journal of Gastroenterology 2006年第26期12卷 4264-4266页

作者： Dimitrios Siablis Zafiria G Papathanassiou Dimitrios Karnabatidis Nikolaos Christeas Konstantinos Katsanos Constantine Vagianos Departments of Interventional Radiology and Surgery University Hospital of Patras RioGreece

splenic arteriovenous fistula （SAVF） accounts for an unusual but well-documented treatable cause of portal hypertension. A case of a 50-year-old multiparous female who developed suddenly portal hypertension due to SAVF formation is presented. The patient suffered from repeated episodes of haematemesis and melaena during the past twelve days and thus was emergently admitted to hospital for management. Clinical and laboratory investigations established the diagnosis of portal hypertension in the absence of liver parenchymal disease. Endoscopy revealed multiple esophageal bleeding varices. Abdominal computed tomography （CT） and transfemoral celiac arteriography documented the presence of a tortuous and aneurysmatic splenic artery and premature filling of an enlarged splenic vein, findings highly suggestive of an SAVF. The aforementioned vascular abnormality was successfully treated with percutaneous transcatheter embolization. Neither recurrence nor other complications were observed.

关键词： splenic artery aneurysm splenic arteriovenous fistula Portal hypertension Transcatheter embolizaUon

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