The development and clinical features of splenic aneurysm associated with liver cirrhosis.
OBJECTIVE
Splenic artery aneurysm (SAA) is usually asymptomatic, but can be fatal if it ruptures. Portal hypertensive patients with varix or splenomegaly are sometimes complicated by SAA. However, there have been no large-scale clinical studies regarding whether liver cirrhosis itself is associated with splenic aneurysm regardless of varix or splenomegaly.


METHODS
In the present study, we retrospectively analyzed 303 cirrhotic patients examined with arteriography. The diagnosis and characteristics of SAAs were determined, and the relation with splenic artery diameter was evaluated.


RESULTS
Nine patients (2.97%) had 12 complicated SAAs. The aneurysms, which measured 4-22 mm in diameter, were all saccular, and occurred commonly in the splenic hilum (50.0%). A correlation was noted between splenic artery diameter and aneurysm diameter (R(2)=0.706). Aneurysm growth was strongly associated with an increase in diameter of the splenic artery trunk (R(2)=0.705), which is closely related to arterial flow.


CONCLUSIONS
SAA is considered a complication of cirrhosis. The increase in splenic artery diameter may result in SAA enlargement and rupture. Elective procedures should be considered based on the follow-up of main trunk or diameter of the splenic artery in addition to SAA size, a known risk factor of aneurysmal rupture.
Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan.
Hajime
H
Sunagozaka
Hirokazu
H
Tsuji
Eishiro
E
Mizukoshi
Kuniaki
K
Arai
Takashi
T
Kagaya
Tatsuya
T
Yamashita
Akito
A
Sakai
Yasunari
Y
Nakamoto
Masao
M
Honda
Shuichi
S
Kaneko
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000209:etiology* / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000209:etiology; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*