scholarly journals Splenic artery aneurysm as a rare cause of an upper GIT bleed

2019 ◽  
Vol 12 (11) ◽  
pp. e232383
Author(s):  
Nolitha Makapi Tisetso Morare ◽  
Charl Bosman ◽  
Akinwumi Babatunde Ogunrombi
Keyword(s):  
Risk Factors ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Peptic Ulcers ◽  
Common Life ◽  
Bleeding Peptic Ulcers ◽  
Ethanol Abuse ◽  
Life Threatening ◽  
History Of

Upper gastrointestinal bleeding (UGIB) is a common life-threatening presentation in the emergency department. Causes are typically divided into variceal and non-variceal bleeds. Non-variceal pathologies typically include bleeding peptic ulcers, haemorrhagic gastritis and Mallory Weiss Tears. Occassionally, less common pathologies are encountered such as Dieulafoy’s lesions, haemosuccus pancreas, haemobilia or aorto-enteric fistula. The following report documents the case of a 49-year-old man who presented with an UGIB. His risk factors included a history of nonsteroidal anti-inflammatory drug, smoking and ethanol abuse. Despite his typical presentation and risk factors, investigation revealed an unusual and rare pathology. He was found to have a giant splenic artery aneurysm, abutting and eroding the gastric mucosa. Diagnosis was made using a combination of gastro-oesophagoscopy and CT scan. Successful treatment consisted of angio-embolisation of the aneurysm.

scholarly journals Pancytopenia in a Patient with Rendu-Osler-Weber Syndrome and Uncommon Vascular Abnormalities

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Nicolò Binello ◽  
Antonio Gasbarrini ◽  
Eleonora Gaetani
Keyword(s):  
Splenic Artery ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Solid Organ ◽  
Vascular Abnormalities ◽  
First Case ◽  
Arteriovenous Shunts ◽  
Weber Syndrome ◽  
History Of ◽  
Sustained Increase

Rendu-Osler-Weber syndrome, or hereditary hemorrhagic teleangiectasia (HHT), is a rare autosomal dominant vascular disorder, characterized by multiple mucocutaneous teleangiectases with recurrent nasal and gastrointestinal bleedings and/or solid-organ arteriovenous shunts. We describe the first case to our knowledge of pancytopenia in a 53-year-old patient, with a known history of HHT and recurrent nasal and gastrointestinal bleedings, who was found to have a major splenic artery aneurysm and other uncommon vascular abnormalities. In the absence of other evident causes of pancytopenia, hypersplenism was diagnosed. The patient underwent coil embolization of the splenic artery aneurysm, followed by rapid and sustained increase of white blood cell and platelet count. Splenic artery aneurysms are extremely uncommon in HHT as only anecdotal cases have been reported to date. However, we believe that the aneurysm critically contributed to the progression of splenomegaly and the development of pancytopenia.

scholarly journals Gastrointestinal Hemorrhage Due to Splenic Artery Aneurysm Pancreatic Duct Fistula in Chronic Pancreatitis

HPB Surgery ◽  
1993 ◽  
Vol 7 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Christian Seiler ◽  
Leslie H. Blumgart
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Gastrointestinal Hemorrhage ◽  
Splenic Artery ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Life Threatening ◽  
Threatening Situation

Gastrointestinal hemorrhage due to splenic artery aneurysm pancreatic duct fistula in chronic pancreatitis is rare. It is, however, important to diagnose this condition particularly in patients having chronic pancreatitis, since it may result in a life-threatening situation. The diagnosis is usually difficult to establish and it may take repeated admissions for intermittent gastrointestinal bleeding until the real source is recognized. Clinical attacks of epigastric pain followed by GI-bleeding 30–40 minutes later are characteristic. Occasionally these attacks are followed by transient jaundice. The present case report describes this rare complication and reviews the current literature.

scholarly journals The therapeutic challenge of giant splenic artery aneurysm: a case repport

2017 ◽  
Vol 15 (3) ◽  
pp. 359-362 ◽  
Author(s):  
Paulo Kauffman ◽  
Antonio Luiz de Vasconcellos Macedo ◽  
Roberto Sacilotto ◽  
Adriano Tachibana ◽  
Sergio Kuzniec ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Abdominal Ultrasound ◽  
Celiac Artery ◽  
Splenic Artery Aneurysm ◽  
Ultrasound Finding ◽  
Large Tumor ◽  
Life Threatening ◽  
Conventional Open Surgery

ABSTRACT Giant splenic artery aneurysm is a rare condition that represents an eminent life threatening for the patient, requiring, therefore, urgent surgical correction. A 61-year-old woman, former smoker, hypertensive, hypercholesterolemic and multipara sought our service because of a large tumor in the mesogastrium, which was an abdominal ultrasound finding. Despite the size of the tumor, the patient was asymptomatic. The angiotomography and the magnetic resonance image of the abdomen were suggestive of giant splenic artery aneurysm with more than 10cm in diameter that was confirmed by an angiography. She underwent surgery, open splenectomy, and partial aneurysmectomy. The approach of the celiac artery, which was ligated, was only possible with medialvisceral rotation because there was no possibility to view it through the anterior access. The histopathological test of aneurysmatic wall revealed atheroma plaques in the intima. The patient progressed without complications and she was discharged cured. In general, giant splenic artery aneurysms are symptomatic, however, as in the case we report, it may be asymptomatic and found in abdominal imaging exam. Although less invasive Interventional methods exist, such as laparoscopy and endovascular techniques, they were considered inappropriate in this case. Conventional open surgery should be the therapy of choice for a giant splenic artery aneurysm.

scholarly journals Surgical treatment of big splenic artery aneurysm: Case report

2009 ◽  
Vol 62 (7-8) ◽  
pp. 363-368
Author(s):  
Milos Kacanski ◽  
Vladimir Markovic ◽  
Janko Pasternak ◽  
Vladan Popovic ◽  
Jovan Pfau ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Visceral Artery ◽  
Transplantation Surgery ◽  
Life Threatening ◽  
Omental Bursa ◽  
Novi Sad ◽  
Chevron Incision

An aneurysm has been defined as a permanent local dilatation of the diameter of an artery by at least 50% of its normal value. A splenic artery aneurysm is most frequently a visceral artery aneurysm and clinically it is usually asymptomatic but potentially life-threatening at the same time, with the incidence of its rupturing being 2-10% and then the mortality rate ranges from 20 to 36%. A 51-year-old female patient was admitted to the Department of Vascular and Transplantation Surgery in Novi Sad having been found to have a big splenic artery aneurysm during the ultrasound examination of her abdomen after cholecystectomy. The additional diagnostic procedure - computerized tomography of the abdomen with i.v contrast subtraction angiography-confirmed the splenic artery aneurysm to have the diameter of 5 cm and therefore the elective surgical treatment was indicated after the preoperative preparation and risk assessment. The aneurysm was exposed through Chevron incision, and the detailed surgical exploration was done after the omental bursa had been opened. The aneurysmectomy and the reconstruction of the splenic artery by the termino-terminal anastomosis were performed after the weakening of the wall had been verified. The biopsies of the liver and the aneurysmal sac were done during the surgery. The pathohistological finding confirmed the atherosclerotic etiology of the aneurysm. Since the postoperative course was normal, the patient was discharged on the eighth postoperative day.

Spontaneous rupture of a splenic artery aneurysm during the third trimester of pregnancy

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Nuri Peker ◽  
Nazif Harun Vicdanlı ◽  
Ahmet Demir ◽  
Mehmet Buğra Bozan ◽  
Savaş Gündoğan
Keyword(s):  
Maternal Death ◽  
Spontaneous Rupture ◽  
Splenic Artery ◽  
Strong Association ◽  
Hypovolemic Shock ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Third Trimester ◽  
Life Threatening ◽  
Threatening Situation

Abstract Spontaneous rupture of a splenic artery aneurysm (SAA) during pregnancy is a rare but life-threatening situation typically presenting with sudden and unexpected fetal and maternal death. The etiology is unclear; however, there is a strong association between pregnancy and the rupture of a SAA. Maternal and fetal prognosis is poor and mortality rates remain at 70% and 90%, respectively. Here, we present a case report of the spontaneous rupture of a SAA at the 35th week of gestation, which presented as suddenly developed hypovolemic shock ending in fetal and maternal death.

scholarly journals Conservative Management of a Splenic Artery Aneurysm in Pregnancy: A Case Report

2020 ◽  
Vol 3 ◽  
Author(s):  
Raleene Gatmaitan ◽  
Keagan Werner-Gibbings ◽  
Morad Sallam ◽  
Rachel Bell ◽  
Panos Gkoutzios
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Conservative Management ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Careful Consideration ◽  
Splenic Artery Aneurysm ◽  
Life Threatening ◽  
In Pregnancy ◽  
Viable Treatment

Splenic artery aneurysms (SAA) are a rare and life-threatening pathology. Ruptured SAA has a mortality rate of up to 25%, with increased rates of rupture in pregnancy, pseudoaneurysm, liver transplantation, portal hypertension, symptomatic SAA and diameter >2 cm. Management of SAA in pregnant women is poorly described in the literature, making treatment of these patients difficult. Furthermore, careful consideration of complications for both the mother and the foetus need to be taken into account. This case report demonstrates that conservative management with monthly surveillance MRI can be used as viable treatment option of an asymptomatic 17 mm splenic artery aneurysm in a pregnant woman.

Endovascular Repair of a Splenic Artery Aneurysm With Anomalous Origin From the Superior Mesenteric Artery

2017 ◽  
Vol 51 (3) ◽  
pp. 152-154 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Francis J. Caputo ◽  
Joseph V. Lombardi
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Recurrent Abdominal Pain ◽  
Anomalous Origin ◽  
Splenic Artery Aneurysm ◽  
History Of

A 22 year old female with a history of recurrent abdominal pain was transferred to our institution with a diagnosis of splenic artery aneurysm identified on imaging. CT angiography of the abdomen and pelvis revealed a partially thrombosed 3.0 cm splenic artery aneurysm without signs of rupture and with an anomalous origin from the superior mesenteric artery. The patient was successfully treated with endovascular exclusion of the aneurysm. Herein we review some of the nuances of endovascular repair of splenic artery aneurysm.

scholarly journals Multiple Giant Splenic Artery Aneurysms Causing Sinistral (Left-Sided) Portal Hypertension

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kemal Beksac ◽  
Derya Karakoc
Keyword(s):  
Portal Hypertension ◽  
Splenic Artery ◽  
Splenic Vein ◽  
Artery Aneurysm ◽  
Normal Liver ◽  
Splenic Artery Aneurysm ◽  
En Bloc ◽  
Artery Ligation ◽  
Multiple Aneurysms ◽  
Life Threatening

Background. Splenic artery aneurysm is the most common type of visceral aneurysms. They are usually asymptomatic and have a potential for rupture and therefore life-threatening hemorrhage. It is rare for them to cause sinistral portal hypertension.Case Report. A 23-year-old female patient presented to our clinic with gastric varices, splenomegaly, pancytopenia, and normal liver functions. She was thus diagnosed with left-sided portal hypertension. Radiologic evaluation showed splenomegaly, splenic vein obstruction, and multiple aneurysms along the splenic artery ranging from 2.5 cm to 7 cm. Splenic artery aneurysm was thought to be the cause of portal hypertension and hypersplenism. We decided splenectomy is the best course of treatment. Pancytopenia could not be corrected preoperatively despite the transfusion treatment. Surgical exploration revealed multiple aneurysms deeply embedded in pancreas. Thrombocyte and erythrocyte transfusion was performed after splenic artery ligation to correct pancytopenia before further intervention. Splenic artery, spleen, and distal pancreas were resected en bloc. Patient’s blood parameters became normal within first postoperative day. Patient had an uneventful postoperative course and was discharged without incident.Conclusion. Splenic artery aneurysms are rare but potentially life-threatening incidents. Therefore, it is important to know the unusual presentations and prepare accordingly.

scholarly journals Spleen-Preserving Surgery in Splenic Artery Aneurysm

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Ulaş Aday ◽  
Emre Bozdağ ◽  
Ebubekir Gündeş ◽  
Selçuk Gülmez ◽  
Kamuran Cumhur Değer
Keyword(s):  
Open Surgery ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Gold Standard Method ◽  
Spleen Preserving ◽  
Clinical Disorder ◽  
Endovascular Interventions ◽  
Life Threatening ◽  
Arterial Anastomosis

Endovascular interventions are increasingly used in the treatment of a splenic artery aneurysm (SAA), which is a rare and life-threatening clinical disorder. However, in cases of SAA rupture, minimally invasive interventions are unsuitable, and open surgery remains the gold standard method. In open surgery, care should be taken to preserve the spleen and its immune function in cases where an arterial segment of sufficient length allows for reconstruction. An SAA was detected in a 51-year-old woman who presented to our polyclinic with left upper quadrant pain. An endovascular intervention was unsuccessful, and open surgery was performed. Approximately 5 cm of aneurysm in the middle segment of the splenic artery was treated by arterial anastomosis, and the spleen was preserved. The patient experienced no postoperative complications and remained asymptomatic at the seventh month of follow-up. The aim of this case report is to emphasize the importance of splenic sparing surgery in cases of SAAs.

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