Splenic Artery Aneurysm

Figures 1&2: Axial contrast-enhanced CT images (2nd image is a maximum-intensity projection image) show a 2-cm saccular aneurysm (arrows) of the mid splenic artery in a 38-year-old woman with idiopathic hepatic cirrhosis, portal hypertension and splenomegaly. CA = celiac artery

Facts About Splenic Artery Aneurysm

• Most common visceral artery aneurysm
• Incidence up to 7% in autopsy series, nearly 1% on abdominal angiographic series
• Most are saccular
• Most are in mid or distal splenic artery
• Women > men

Etiology

1. Degenerative from underlying medial fibrodysplasia (atherosclerosis not considered to be the primary etiology)
2. Inflammatory: almost always related to pancreatitis and pseudocysts
3. Posttraumatic
4. Pregnancy related: high association with mortality for mother and fetus with ruptured aneurysms

Treatment

Most surgical literature recommends repair if

• Larger than 2 cm
• Enlarging on follow ups
• Pregnant patients or in women of childbearing age who might become pregnant

Open repair or endovascular therapy

Reference:

Kandarpa K. Peripheral Vascular Intervention. Lippincott Williams & Wilkins, 1st edition (October 1, 2007).