Splenic artery aneurysm
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The splenic artery is the third most common site of intraabdominal aneurysms after abdominal aortic aneurysms and the iliac artery aneurysms. Splenic artery aneurysm is four times more common in women but approximately three times more likely to rupture in men. It is associated with hypertension, portal hypertension, cirrhosis, liver transplantation, and pregnancy. In contrast to aneurysms of larger vessels such as the aorta, atherosclerosis is not considered to be the underlying cause. It is usually smaller than 3 cm. It is most commonly located in the distal portion of the artery and peripheral calcification is common
Natural History, Complications and Prognosis
- Rupture occurs in approximately 2-3%.
- Frequency of rupture is increased with liver transplantation, portal hypertension, and pregnancy.
Diagnosis
- Splenic artery aneurysms can appear well defined and homogeneous on contrast-enhanced CT.
- Mural thrombus may be present
- Peripheral calcification is apparent in many cases
Treatment
- Treatment of symptomatic splenic artery aneurysms should be performed.
- In addition, several high-risk groups of asymptomatic patients should also be considered for repair
- Pregnant women or women of childbearing age
- Liver transplant or patients with cirrhosis and portal hypertension.