head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2022, vol. 28, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2022282.4384
Published online: 03 June 2022

Review article
J of IMAB. 2022 Apr-Jun;28(2):4384-4388
ANEURYSM OF SPLENIC ARTERY. INCIDENCE, CLINIC, DIAGNOSIS, TREATMENT. REVIEW AND CASES FROM PRACTICE
Sergey Iliev1ORCID logo, Lubomir Beshev2, Paulina Vladova1ORCID logo Corresponding Autoremail,
1) Department of Propedeutics of Surgical Diseases, Medical University, Pleven, Bulgaria.
2) Department of Vascular Surgery, Medical University, Pleven, Bulgaria.

ABSTRACT:
Aneurysms of splenic artery are the most common visceral aneurysms. There are true aneurysms and pseudoaneurysms. True aneurysms develop against the background of artery wall weakness. Pseudoaneurysms result from a rupture of the intima of the vessel wall with subsequent dissection of blood into a false lumen and formation of a periarterial hematoma. They are detected as an incidental finding without any clinical manifestation.
The aim of this article is to present two clinical cases of a ruptured aneurysm of the splenic artery in our practice.
The mortality rate after rupture of the splenic artery aneurysm varies from 25% to 40%. Under emergency conditions, the time for diagnosis is scarce and limited by the hemodynamic status of the patient.
With increasing the possibilities of diagnostic imaging, the chances for minimally invasive treatment of incidentally detected pseudoaneurysms of the splenic artery improve.
The conditions for successful management of this pathology include organization of emergency surgical care and collaboration between surgical teams.

Keywords: splenic artery aneurysm, clinical diagnostic approach,

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Please cite this article as: Iliev S, Beshev L, Vladova P. Aneurysm of splenic artery. Incidence, clinic, diagnosis, treatment. Review and cases from practice. J of IMAB. 2022 Jan-Mar;28(1):4384-4388.
DOI: 10.5272/jimab.2022282.4384

Corresponding AutorCorrespondence to: Paulina Vladova, Medical University of Pleven; 37, Georgi Kochev, str. Pleven, 5800, Bulgaria; E-mail: p.t.vladova@abv.bg

REFERENCES:
1. Kassem MM, Gonzalez L. Splenic Artery Aneurysm. 2021 Jul 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. [PubMed]
2. van Rijn MJ, Ten Raa S, Hendriks JM, Verhagen HJ. Visceral aneurysms: Old paradigms, new insights? Best Pract Res Clin Gastroenterol. 2017 Feb;31(1):97-104. [PubMed]
3. Puri S, Nicholson AA, Breen DJ. Percutaneous thrombin injection for the treatment of a post-pancreatitis pseudoaneurysm. Eur Radiol. 2003 Dec;13 Suppl 4:L79-82. [PubMed]
4. Flati G, Andren-Sandberg A, La Pinta M, Porowska B, Carboni M. Potentially fatal bleeding in acute pancreatitis: pathophysiology, prevention and treatment. Pancreas. 2003; 26:8-14.
5. Agrawal GA, Johnson PT, Fishman EK. Splenic artery aneurysms and pseudoaneurysms: clinical distinctions and CT appearances. AJR Am J Roentgenol. 2007 Apr;188(4):992-9. [PubMed]
6. Trastek VF, Pairolero PC, Joyce JW, Hollier LH, Bernatz PE. Splenic artery aneurysms. Surgery. 1982; 91:694-699.
7. Stanley JC, Thomas NW, Fry WJ. Splanchnic artery aneurysms. Arch Surg. 1970; 101:689-697.
8. Bedford PD, Lodge B. Aneurysm of the splenic artery. Gut. 1960; 1:312-320.
9. Arghami A, Krajewski AC, Gloviczki P, Leduc C, Lin PT. Open staged repair of splenic and extensive superior mesenteric artery aneurysms. J Vasc Surg. 2019 Apr;69(4):1252-1256. [PubMed]
10. Qiu P, Zhu H. Endovascular Repair of Anomalous Splenic Artery Aneurysm with Systemic Lupus Erythematosus. Ann Vasc Surg. 2019 Feb;55:309.e1-309.e4. [PubMed]
11. Therakathu J, Panwala HK, Bhargava S, Eapen A, Keshava SN, David D. Contrast-enhanced Computed Tomography Imaging of Splenic Artery Aneurysms and Pseudoaneurysms: A Single-center Experience. J Clin Imaging Sci. 2018 Aug 24;8:37. [PubMed]
12. Rokke O, Sondenaa K, Amundsen S, Bjerke-Larssen T, Jensen D. The diagnosis and management of splanchnic artery aneurysms. Scand J Gastroenterol. 1996; 31:737-743.
13. Veluppillai C, Perreve S, de Kerviler B, Ducarme G. [Splenic arterial aneurysm and pregnancy: A review.] [in French] Presse Med. 2015 Oct;44(10):991-4. [PubMed]
14. Kaya M, Baran Ş, Güya C, Kaplan MA. Prevalence and predictive factors for development of splenic artery aneurysms in cirrhosis. Indian J Gastroenterol. 2016 May;35(3):201-6. [PubMed]
15. Kim JH, Chung HS, Kim JH, Park SY, Lee SB, Do BS. Splenic artery aneurysm with the double-rupture phenomenon. Clin Exp Emerg Med. 2017 Jun 30;4(2):113-116. [PubMed]
16. Dave SP, Reis ED, Hossain A, Taub PJ, Kerstein MD, Hollier LH. Splenic artery aneurysm in the 1990s. Ann Vasc Surg. 2000; 14:223-229.
17. Tessier DJ, Stone WM, Fowl RJ, Abbas MA, Andrews JC, Bower TC, et al. Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg. 2003 Nov;38(5):969-74. [PubMed]
18. Abbas MA, Stone WM, Fowl RJ, Gloviczki P, Oldenburg WA, Pairolero PC еt al. Splenic artery aneurysms: two decades experience at Mayo clinic. Ann Vasc Surg. 2002 Jul;16(4):442-9. [PubMed]
19. Björck M, Koelemay M, Acosta S, Bastos Goncalves F, Kölbel T, Kolkman JJ, et al. Editor's Choice - Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017 Apr;53(4):460-510. [PubMed]
20. Stanley JC, Wakefield TW, Graham LM, Whitehouse WM Jr, Zelenock GB, Lindenauer SM. Clinical importance and management of splanchnic artery aneurysms. J Vasc Surg. 1986; 3:836-840.
21. Trastek VF, Pairolero PC, Bernatz PE. Splenic artery aneurysms. World J Surg. 1985; 9:378-383.
22. Mattar SG, Lumsden AB. The management of splenic artery aneurysms: experience with 23 cases. Am J Surg. 1995; 169:580-584.
23. Remy D, Linder JL. Splenic aneurysm rupture: case report and review of the literature. Acta Chir Belg. 1993; 93:54-57.
24. Huang IH, Zuckerman DA, Matthews JB. Occlusion of a giant splenic artery pseudoaneurysm with percutaneous thrombin-collagen injection. J Vasc Surg. 2004; 40:574-577.
25. LiPuma JP, Sachs PB, Sands MJ, Stuhlmiller S, Herbener TE. Angiography/interventional case of the day: splenic artery pseudoaneurysm associated with pancreatitis. AJR. 1997; 169:259, 262-263.
26. Khoshnevis J, Lotfollahzadeh S, Sobhiyeh MR, Najd Sepas H, Abbas Nejad M, et al. Ruptured aneurysm of the splenic artery: a rare cause of abdominal pain after blunt trauma. Trauma Mon. 2013 Spring;18(1):46-9. [PubMed]
27. - Agrawal GA, Johnson PT, Fishman EK. Splenic artery aneurysms and pseudoaneurysms: clinical distinctions and CT appearances. AJR Am J Roentgenol. 2007 Apr;188(4):992-9. [PubMed]
28. Derchi LE, Biggi E, Cicio GR, Bertoglio C, Neumaier CE. Aneurysms of the splenic artery: noninvasive diagnosis by pulsed Doppler sonography. J Ultrasound Med. 1984; 3:41-44.
29. Lin CT, Chiang CW, Hsieh HC. Extrasplenic pseudoaneurysm.: the role of color flow Doppler ultrasound in diagnosis. Jpn Heart J. 1999; 40:365-368.
30. Pilleul F, Beuf O. Diagnosis of splanchnic artery aneurysms and pseudoaneurysms, with special reference to contrast-enhanced 3D magnetic resonance angiography: a review. Acta Radiol. 2004; 45:702-708.
31. Jaffe TA, Nelson RC, Johnson GA, Lee ER, Yoshizumi TT, Lowry CR, et al. Optimization of multiplanar reformations from isotropic data sets acquired with 16-detector row helical CT scanner. Radiology. 2006 Jan;238(1):292-9. [PubMed]
32. de Perrot M, Buhler L, Schneider PA, Mentha G, Morel PR. Do aneurysms and pseudoaneurysms of the splenic artery require different surgical strategy? Hepatogastroenterology. 1999; 46:2028-2032.
33. Arepally A, Dagli M, Hofmann LV, Kim HS, Cooper M, Klein A. Treatment of splenic artery aneurysm with use of a stent-graft. J Vasc Interv Radiol. 2002; 13:631-633.
34. Dave SP, Reis ED, Hossain A, Taub PJ, Kerstein MD, Hollier LH. Splenic artery aneurysm in the 1990s. Ann Vasc Surg. 2000; 14:223-229.
35. Guillon R, Garcier JM, Abergel A, Mofid R, Garcia V, Chahid T, et al. Management of splenic artery aneurysms and false aneurysms with endovascular treatment in 12 patients. Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):256-60. [PubMed]
36. Therakathu J, Panwala HK, Bhargava S, Eapen A, Keshava SN, David D. Contrast-enhanced Computed Tomography Imaging of Splenic Artery Aneurysms and Pseudoaneurysms: A Single-center Experience. J Clin Imaging Sci. 2018 Aug 24;8:37. [PubMed]
37. Qiu P, Zhu H. Endovascular Repair of Anomalous Splenic Artery Aneurysm with Systemic Lupus Erythematosus. Ann Vasc Surg. 2019 Feb;55:309.e1-309.e4. [PubMed]
38. Iyori K, Mitsumori Y, Kato D,  Okuwaki H, Ariizumi K, Hashimoto R, еt al. Open reconstruction of multiple huge superior mesenteric artery aneurysms. J Vasc Surg Cases Innov Tech. 2020 Dec;6(4):571-575. [Crossref]
39. Wernheden E, Brenøe AS, Shahidi S. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm. J Vasc Surg Cases Innov Tech. 2017 Dec 18;3(4):240-242. [PubMed]
40. Effraemidou E, Souftas V, Kofina K, Karanikas M, Lyratzopoulos N. Spontaneous rupture of a splenic artery aneurysm treated with a spleen-preserving procedure: a case report. J Surg Case Rep. 2020 Feb;2020(2):rjz412. [Crossref].

Received: 08 September 2021
Published online: 03 June 2022

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