
Multiple aneurysms splenic; surgical exclusion with conservation of the spleen
Author(s) -
Héctor Bizueto-Rosas,
José Ángel Barajas-Colón,
Ivan Delgadillo-de la O,
Nahieli Patricia Malo-Martínez,
Hugo Alonso Pérez-González,
Noemí Antonia Hernández-Pérez
Publication year - 2016
Publication title -
cirugía y cirujanos
Language(s) - English
Resource type - Journals
ISSN - 2444-0507
DOI - 10.1016/j.circen.2015.12.003
Subject(s) - medicine , splenic artery , radiology , etiology , surgery , angiography , aneurysm , portal hypertension , cirrhosis
BackgroundAneurysm of the splenic artery is diagnosed when the diameter of the splenic artery is greater than 1cm. It occupies third place among abdominal aneurysms. It is more frequent in women (4:1). It is associated with trauma, haemodynamics and local hormonal effects during pregnancy, portal hypertension (including the Caroli syndrome), arterial degeneration, atherosclerosis, and liver transplantation. It is difficult to diagnose, and it generally presents as ruptured, thus once the diagnosis is made, the surgical approach is indicated due to its high mortality.Clinical caseFemale of 66 years of age with a diagnosis of splenic artery aneurysm, with pulsing sensation at epigastric level of 8 months onset. On physical examination there is a palpable throbbing mass of 9cm of diameter approximately, for which she was admitted. The computed tomography angiography with reconstruction showed three splenic aneurysms. Two were tied and the larger one was repaired by endo-aneurysmorrhaphy.DiscussionVisceral aneurysms are extremely rare. They are currently increasing and are the third leading cause of cardiovascular death, as morbidity/mortality is high. The surgical treatment must be done selectively according to their size. Selection of the surgical techniques depends on the anatomic location and the need for revascularisation, the aetiology and the experience of the surgeon.ConclusionA review has been presented on the advances in diagnostic, and management, concluding that the best is to preserve the spleen, and whatever the technique it must be performed by trained surgeons