Splenic artery aneurysms encountered in the ED: 10 years' experience.
OBJECTIVE
Our objective was to report 7 cases of splenic artery aneurysm (SAA) encountered in the emergency department (ED).


METHODS
A retrospective survey of our ED database revealed 7 cases of SAA (6 men, 1 woman; mean age, 56 years) of 651,347 ED visits over the last decade. Their clinical and imaging features, management, and outcomes were evaluated.


RESULTS
Splenic artery aneurysm in the ED was rare (prevalence, 0.011%). Common presentations included acute abdomen (n = 5) and shock (n = 2). Five cases had liver cirrhosis and portal hypertension. Abdominal radiographs (n = 7) revealed 2 atherosclerotic patients with SAA. Abdominal computed tomography (n = 7) depicted all SAAs (size, 1.5-8 cm; mean, 3.8 cm). Four ruptured SAAs were successfully managed with coils embolization. Among them, 1 patient with ruptured mycotic SAA also received surgery, but the patient died of Klebsiella sepsis 3 months later.


CONCLUSIONS
In the ED, ruptured SAA should be included as a rare differential consideration of acute abdomen, especially in middle-aged men with liver cirrhosis and portal hypertension. Although SAA may be an unexpected computed tomographic finding, once diagnosed, endovascular treatment is recommended.
Liu
Chu-Feng
CF
Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, College of Medicine, Kaohsiung 833, Taiwan.
Kung
Chia-Te
CT
Liu
Ber-Ming
BM
Ng
Shu-Hang
SH
Huang
Chung-Cheng
CC
Ko
Sheung-Fat
SF
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D012769:Shock / Q000209:etiology; D013157:Splenic Artery; D013624:Taiwan; D016896:Treatment Outcome