Open AccessDual-interventional therapy for multiple splenic artery aneurysms in a patient with portal hypertension
Author(s) -
Hongtao Niu,
Sha Junfeng,
Jianli An,
Zibo Zou,
Yanchao Dong
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000015205
Subject(s) - medicine , splenic artery , portal hypertension , radiology , splenic infarction , portal venous pressure , embolization , portal venous system , splenectomy , splenic vein , thrombosis , surgery , transjugular intrahepatic portosystemic shunt , angiography , aneurysm , cirrhosis , spleen
Rationale: Portal hypertension (PHT) is either a significant risk factor of development of splenic artery aneurysm (SAA), or predisposing factor of rupture. Patient concerns: A 57-year-old patient was admitted to our hospital because of multiple SAAs with PHT, suffered from episodes of haematemesis. Diagnosis: Emergency ultrasound of the abdomen showed remarkable cirrhosis and splenomegaly. Two days later, CT angiography reveal two SAA located in the splenic artery, as well as splenomegaly and features of PHT. Interventions: Transjugular intrahepatic portosystemic shunt (TIPS) was performed to decrease portal venous pressure and control esophagogastric variceal hemorrhage. Coil embolization of the main splenic artery was performed to complete thrombosis of the two SAAs and relieve critical hypersplenism. Outcomes: After 3 months, follow-up enhanced CT confirmed complete thrombosis of the main splenic artery and the two aneurysm sac, and partial splenic infarction (approximately 50%). Lessens: TIPS can control easophagogastric variceal hemorrhage and decrease portal venous pressure, coil embolization of the main splenic artery can promote permanent thrombosis of aneurysm sac and relieve hypersplenism.