Multiple aneurysms splenic; surgical exclusion with conservation of the spleen

• Published in: Cirugia y cirujanos Vol. 84; no. 1; p. 58
• Main Authors: Bizueto-Rosas, Héctor, Barajas-Colón, José Ángel, Delgadillo-de la O, Ivan, Malo-Martínez, Nahieli Patricia, Pérez-González, Hugo Alonso, Hernández-Pérez, Noemí Antonia
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.01.2016
• Subjects: Aged; Aneurysm - diagnostic imaging; Aneurysm - surgery; Angiography; Balloon Embolectomy; Female; Humans; Ligation; Organ Sparing Treatments - methods; Splanchnic Circulation; Spleen - blood supply; Spleen - surgery; Splenic Artery - diagnostic imaging; Splenic Artery - surgery; Tomography, X-Ray Computed; Spleen; Arteria esplénica; Resección quirúrgica; Splenic artery; Aneurisma; Aneurysm; Conservation; Conservación; Surgical resection; Bazo
• ISSN: 2444-054X
• DOI: 10.1016/j.circir.2015.06.011

Aneurysm 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. Female 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 9 cm 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. Visceral 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. A 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.