GIANT ANEURYSM OF THE SPLENIC ARTERY: CASE REPORT AND LITERARY REVIEW

Abstract

Introduction: The authors describe an unusual case of giant aneurysm of the splenic artery. The problem of deciding between endovascular and open vascular surgery and what are the tools necessary to choose the most appropriate procedure are discussed in this report.

Case Report: A man 55 years old was admitted to the hospital for an unspecified abdominal pain. Subsequent examinations (TC and angiography) showed a large aneurysm of the splenic artery without any sign of rupture. Endovascular treatment was excluded because of the extreme tortuosity of the artery; the patient underwent open surgical operation of legation of the aneurysm and splenectomy. The patient was discharged in 6th postoperative day.

Discussion: Splenic artery aneurysm are usually an occasional finding but they are related with an important risk of rupture and mortality; elective treatment both surgical and endovascular is recommended. Emergency surgery is still complicated with an high rate of mortality related to the patient’s comorbidities. Endovascular treatment by covered stent-graft or selective embolization may represent the best option but it can be proposed only after an accurate selection of the patients. Endovascular treatment also seems to be feasible even in emergency but only in very selected cases and in expert vascular-interventional units. Laparoscopic surgery has been performed only sporadically.

Conclusions: We would like to point out that nowadays the treatment of splenic artery aneurysm doesn’t give a real choice and each case should be assessed singularly with the purpose to choose the best therapeutic approach either percutaneous or surgical.