Introduction. Splenic artery aneurysm (SAA) represents the third cause of
abdominal aneurysms, just after abdominal aorta and iliac arteries
aneurysms, with overall prevalence of 1%. Pancreatitis has been linked with
pseudoaneurysm formation of SA due to destruction of arterial wall by
pancreatic enzymes, however true SAA associated with pancreatitis hasn?t
been described yet. We are presenting the first case of true SAA in a
patient with chronic pancreatitis and primary biliary cholangitis
successfully treated by surgical excision, direct arterial reconstruction
and spleen preservation. Case outline. A 74-years-old male patient was
admitted for multidetector computed tomography (MDCT) angiography due to
suspected SAA and renal artery aneurysm (RAA). He was previously treated for
chronic pancreatitis and primary biliary cholangitis. Upon admission, CT
arteriography showed SAA 32 mm in diameter and RAA 12 mm with SAA being in
direct contact with superior margin of the pancreas. Surgical treatment of
SAA was indicated while RAA was treated conservatively. Intraoperatively,
SAA adherent to the superior margin of pancreas was noted, followed by
complete exclusion of the aneurysm and end-to-end splenic artery
anastomosis. Histopathology showed atherosclerotic degeneration of arterial
wall with all three layers presenting as true aneurysm. Two years after the
surgery control CT angiography showed regular postoperative findings without
further progression of RAA. Conclusion. This is the first case to describe
a true SAA aneurysm originated on the field of previous episodes of chronic
pancreatitis and primary biliary cholangitis. Surgical treatment including
aneurysm resection and direct arterial reconstruction with spleen
preservation showed satisfactory results.
Splenic artery as a conduit to facilitate visceral arterial reconstruction
