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

Background Splenic artery aneurysm (SAA) rupture is life-threatening. Although elective transcatheter arterial embolization (TAE) suggested low in-hospital death in previous studies, there has been no large multi-center study of elective TAE for SAA. Purpose To examine the short-term outcomes of TAE for splenic artery aneurysm (SAA) and analyze the factors associated with the outcomes, including liver cirrhosis, using a nationwide administrative inpatient database. Material and Methods We identified patients who received elective TAE with a principal diagnosis of SAA. We assessed the patient background characteristics, comprising age, sex, and specific co-morbidities, including liver cirrhosis. The outcomes included the rate of TAE-related complications (acute pancreatitis, splenic infarction, splenic abscess, or intraperitoneal hematoma), length of stay, and in-hospital mortality. Results Among 18.3 million inpatients in the database between July 2010 and March 2013, we identified 534 patients who received elective TAE for SAA at 229 participating hospitals. Fifty-four (10.1%) patients had liver cirrhosis. No in-hospital deaths were observed. Thirty-two (6.0%) patients had at least one TAE-related complication. A multivariate linear regression analysis revealed that liver cirrhosis was significantly associated with longer length of stay (9.5 days; 95% confidence interval [CI], 7.0–12.0 days; P < 0.001). A logistic regression analysis showed that liver cirrhosis was not significantly associated with TAE-related complications (odds ratio, 0.99; 95% CI, 0.29–3.39; P = 0.980). Conclusion The results revealed no in-hospital mortality and a low complication rate associated with elective TAE for SAA including liver cirrhosis patients.

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Spontaneous rupture of splenic artery aneurysm in pregnancy: A case report and review of the literature

Polish Annals of Medicine ◽

10.29089/2020.20.00139 ◽

2020 ◽

Author(s):

Wojciech Tomasz Zdanowski ◽

Maciej Eliszewski ◽

Janina Lipińska ◽

Mariusz Przybyłowicz ◽

Piotr Malinowski ◽

...

Keyword(s):

Case Report ◽

Splenic Artery ◽

Hypovolemic Shock ◽

Artery Aneurysm ◽

Study Patient ◽

Review Of The Literature ◽

Fetal Survival ◽

Visceral Artery Aneurysms ◽

In Pregnancy

Introduction: Splenic artery aneurysms (SAAs) are the most common (60%) of visceral artery aneurysms with the possibility of rupture. SAA rupture is associated with 20% mortality, which increases disproportionately to 75% in pregnant women, with fetal the mortality rate of 95%. Aim: We present a discussion based on the case report with a review of the literature on ruptured SAA in pregnancy as well as possible treatment options, complications and prognosis. Case study: Patient, 40-year-old pregnant woman, gravida 2, para 1, 33 week of pregnancy, with ruptured SAA, underwent cesarean section, splenectomy, and hypovolemic shock treatment. The outcomes of the mother and neonates were good. Postoperative recovery was complicated by right-sided pneumothorax. Results and discussion: 87% of patients with SAA are females. In our analysis of cases, with ruptured SAA in pregnancy, the parity may be the factor that influences the maternal and fetal outcomes. In third trimester of pregnancy (as in our case study) the most often mistaken indication for laparotomy was a suspected placental abruption. Conclusions: Ruptured SAA during pregnancy should be considered as one of the non-obstetric causes of intraabdominal bleeding. Careful observation of the patient from the onset of symptoms is a key approach that increases maternal and fetal survival.

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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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Bleeding Esophageal Varices and Portal Hypertension Caused by Arteriovenous Fistula of Splenic Artery

HPB Surgery ◽

10.1155/1990/49734 ◽

1990 ◽

Vol 3 (1) ◽

pp. 53-57 ◽

Cited By ~ 5

Author(s):

Moshe Shleapnik ◽

Baruch Shpitz ◽

Annette Siegal ◽

Alex Dinbar

Keyword(s):

Portal Hypertension ◽

Liver Disease ◽

Superior Mesenteric Artery ◽

Arteriovenous Fistula ◽

Chronic Liver Disease ◽

Esophageal Varices ◽

Mesenteric Artery ◽

Splenic Artery ◽

Bleeding Esophageal Varices ◽

Splenic Arteriovenous Fistula

Splenic arteriovenous fistula is a rare but curable cause of portal hypertension. This report describes a patient with such a disorder, presenting with bleeding esophageal varices and ascites. It emphasises the importance of performing selective catheterization of the celiac and superior mesenteric artery in all patients with signs of portal hypertension without evidence of chronic liver disease. Etiopathology and management are discussed.

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