45 years old female patient with chief complaint of abdominal vague pain

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Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : mersad mehrnahad

Case Section

Abdominal Imaging

Patient's Information

Gender : Male
Age : 45

Clinical Summary

45 years old female patient with chief complaint of abdominal vague pain

Imaging Findings

a vascular lesion measures 68*72 mm in tract of splenic artery in favor of splenic artery aneurysm with partial thrombosis

Differential Diagnosis

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Final Diagnosis

splenic artery aneurysm with partial thrombosis

Discussion (Related Text)

The splenic artery is the commonest site of visceral arterial aneurysm formation as well as the 3rd commonest site of aneurysm formation in the abdomino-pelvic region (after the aorta and iliac vessels). Aneurysms are usually saccular in configuration. They can either be in the form of a
•splenic artery true aneurysm: (much more common)
•splenic artery pseudoaneurysm
Most often splenic artery aneurysms are detected incidentally on imaging for some other cause. Occasionally they can present acutely with a rupture .
Associations
•atherosclerosis
•fibromuscular dysplasia
•pregnancy
•vasculitides
•cirrhosis 3
•portal hypertension 3
The overall risk of rupture is thought to be ~2-10%. However in an event of rupture there is a relatively high mortality rate of ~36% .
Follow-up of incidentally-detected splenic artery aneurysms :
• < 2cm ◦spontaneous rupture is rare 1 year follow up, if no risk factors follow up interval may be extended if other comorbidities are present, or if there is a decreased life expectancy •≥2 cm ◦endovascular therapy should be considered coil embolisation is increasingly used to treat larger aneurysms rapidly increasing size, presence in a premenopausal woman, cirrhosis, and symptomatic aneurysm may warrant intervention, regardless of size

References

http://radiopaedia.org/articles/splenic-artery-aneurysm