A rare case of gastric varices and splenic artery aneurysm secondary to splenic arteriovenous fistula

A 33-year-old male with no past medical history presented with a few months of fatigue and reduced exercise tolerance and was found to have iron-deficiency anemia. An esophagogastroduodenoscopy revealed a cluster of isolated gastric fundal varices with high-risk stigmata. Serologic workup for cirrhosis was negative, and a FibroScan measured liver stiffness at 4.2 kilopascals. Computed tomography (CT) of his abdomen and pelvis showed non-cirrhotic portal hypertension, as well as the presence of a splenic arteriovenous (AV) fistula and splenic artery aneurysm (SAA). Resection of the fistula, SAA, and spleen completely resolved the gastric varices and anemia.

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Splenic arteriovenous fistula accompanied by splenic artery aneurysm associated with acute-onset portal hypertension and gastrointestinal bleeding: case report and literature review

Annals of Vascular Surgery ◽

10.1016/j.avsg.2021.06.029 ◽

2021 ◽

Author(s):

Yating Zhu ◽

Jiang Xiong ◽

Feng Liu ◽

Wei Guo

Keyword(s):

Case Report ◽

Portal Hypertension ◽

Literature Review ◽

Gastrointestinal Bleeding ◽

Arteriovenous Fistula ◽

Splenic Artery ◽

Artery Aneurysm ◽

Acute Onset ◽

Splenic Artery Aneurysm ◽

Splenic Arteriovenous Fistula

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Idiopathic splenic arteriovenous fistula without splenic artery aneurysm

BMJ Case Reports ◽

10.1136/bcr-2015-209688 ◽

2015 ◽

Vol 2015 (apr22 1) ◽

pp. bcr2015209688-bcr2015209688

Author(s):

S. Ono ◽

H. Obara ◽

M. Shimoda ◽

Y. Kitagawa

Keyword(s):

Arteriovenous Fistula ◽

Splenic Artery ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm ◽

Splenic Arteriovenous Fistula

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Embolization of a Giant Splenic Artery Aneurysm with Only Proximal Coil Embolization: A Case Report

International Journal of Angiology ◽

10.1055/s-0032-1306194 ◽

2003 ◽

Vol 12 (03) ◽

pp. 209-210

Author(s):

Michael Herskowitz ◽

Yair Safriel ◽

Virgilio Gillego

Keyword(s):

Case Report ◽

Coil Embolization ◽

Splenic Artery ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm

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Incidental Splenic Artery Aneurysm

Journal of the Royal Society of Medicine ◽

10.1177/014107680209500911 ◽

2002 ◽

Vol 95 (9) ◽

pp. 460-461 ◽

Cited By ~ 7

Author(s):

R Kenningham ◽

M J Hershman ◽

R G Mcwilliams ◽

F Campbell

Keyword(s):

Splenic Artery ◽

Artery Aneurysm ◽

Splenic Artery Aneurysm

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Splenic artery aneurysm in Sjögren’s syndrome

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2019.1082 ◽

2019 ◽

Vol 89 (2) ◽

Author(s):

Cuneyt Tetikkurt ◽

Zeynep Ferhan Ozseker ◽

Fatma Gülsüm Karakaş

Keyword(s):

Sjögren’S Syndrome ◽

Splenic Artery ◽

Sjögren's Syndrome ◽

Pulmonary Function Tests ◽

Artery Aneurysm ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Splenic Artery Aneurysm ◽

Arterial Blood ◽

Sjögren‘S Syndrome

A 40-year-old female presented with cough, exertional dyspnea, abdominal pain with distention, fatigue, dry eyes and dry mouth. Past history revealed asthma. Physical examination was normal except for tachypnea. We found leukocytosis, azygos fissure on chest X-ray along with normal pulmonary function tests and arterial blood gases. Thorax computed tomography (CT) revealed bronchiectasis and ground glass opacities in both lungs. Abdominal CT demonstrated thrombosed proximal splenic artery aneurysm. Further diagnostic procedures were done and according to the positive Schirmer test and compatible histopathologic findings of the salivary gland, diagnosis of primary Sjögren’s syndrome was established. Splenic artery aneurysm is rare occurring in less than 1% of the population that usually appears as an incidental finding. This is the first case in literature that introduces Sjögren’s syndrome as a risk factor for splenic artery aneurysm. The silent presentation of the splenic artery aneurysm should previse the clinicians that such an occurrence may cause a significant diagnostic dilemma.

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