How is splenic artery aneurysm treated?

How is splenic artery aneurysm treated?

Fusiform true aneurysms are better treated with a stent graft (covered stent), while tortuous, saccular aneurysms are treated with aneurysmal coiling techniques. Pseudoaneurysms can be treated with embolization using liquid embolic agents to thrombose the inflow and outflow arteries or filling the sac itself.

Does splenic artery supply the stomach?

The splenic artery is one of the three branches of the celiac trunk, which supplies the spleen as well as large parts of the stomach and pancreas.

What causes a splenic artery aneurysm to rupture?

Most of the aneurysms are caused by degenerative atherosclerosis or portal hypertension. The risk of rupture is about 5% [2], but in a study at a Taiwanese ED, 4 of 7 patients with splenic artery aneurysm developed an aneurysm rupture [3].

What causes splenic artery pseudoaneurysm?

The causes of splenic artery pseudoaneurysm include pancreatitis (Fig. 6A, 6B), trauma, iatrogenic and postoperative causes, and, rarely, peptic ulcer disease [5].

What size splenic artery aneurysm requires surgery?

A symptomatic aneurysm, an aneurysm of any diameter in a pregnant woman or a woman of childbearing age, and an aneurysm >2 cm are all strong indications for surgery because of a significantly increased risk for splenic artery rupture.

What are the symptoms of a splenic artery aneurysm?

Patients with a splenic artery aneurysm before rupture are fairly asymptomatic; vague epigastric pain, left upper quadrant pain, and left shoulder pain are among the most common complaints. Radiologic studies for the diagnosis of splenic artery aneurysm include plain abdominal film, ultrasound, and angiography.

How do you know if you have a splenic artery?

The splenic artery is one of the terminal branches of the celiac trunk, passing left from the celiac axis across the left crus of diaphragm and left psoas muscle. It is a tortuous artery, running superior to the pancreas before turning forward into the splenorenal ligament to the hilum of the spleen.

What are the chances of surviving aneurysm surgery?

Surgeons and hospitals have no central board accrediting them on their performance of aneurysm surgery, nor are they required to publish their own track record in this area. Studies in medical journals suggest that the death rate ranges from zero to 7%, and the complication rate from 4% to 15%.

How can you tell the difference between an aneurysm and a pseudoaneurysm?

A saccular-shaped aneurysm bulges or balloons out only on one side. A pseudoaneurysm, or false aneurysm, is not an enlargement of any of the layers of the blood vessel wall. A false aneurysm may be the result of a prior surgery or trauma. Sometimes, a tear can occur on the inside layer of the vessel.

What size should a splenic artery aneurysm be?

In the absence of guidelines, the main recommended indications for intervention of splenic artery aneurysm are rupture, aneurysm size larger than 2 or 2.5 cm, growth of the aneurysm by 3 to 5 mm or more during surveillance regardless of initial size, symptoms, women of childbearing age, portal hypertension, and planned …

What is normal size of splenic artery?

The median internal diameter of the splenic artery was 5.35 mm (IQR: 4.67-6.18 mm) in patients with cirrhosis and portal hypertension and 4.60 mm (IQR: 4.32-5.32 mm) in healthy controls.

Risk of rupture increases with liver transplantation, portal hypertension, and pregnancy. A ruptured splenic artery aneurysm usually presents with sudden onset left upper quadrant abdominal pain followed by hemodynamic instability, and gastrointestinal bleeding 14.

Which is the 3rd most common visceral artery aneurysm?

Splenic artery aneuryms are the commonest visceral arterial aneurysm formation as well as the 3rd commonest abdominal aneurysm (after the aorta and iliac vessels). Aneurysms are usually saccular in configuration and they can either be in the form of a true aneurysm (much more common) or as a pseudoaneurysm.

Can a pseudoaneurysm be a true aneurysm?

Aneurysms are usually saccular in configuration and they can either be in the form of a true aneurysm (much more common) or as a pseudoaneurysm. This article focus on the true splenic artery aneurysm, please refer on splenic artery pseudoaneurysms for a specific discussion on this entity.

What causes a double rupture of the splenic artery?

The so-called “double rupture” phenomenon occurs when initial spontaneous stabilization followed by subsequent sudden circulatory collapse is experienced. This is caused by initial bleeding collecting into the lesser sac then followed by flooding into the peritoneal cavity 15 .

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