title: Giant Splenic Artery Pseudoaneurysm: A Case Report and Literature Review.
abstract: Splenic artery aneurysms (SAAs) are the third most frequent intra-abdominal aneurysm, following abdominal aorta and iliac artery aneurysms. SAAs are classified according to their involvement of arterial wall layers: true aneurysms involve all 3 layers (intima, media, and adventitia), and pseudoaneurysms involve only one or two. Herein we present a new case of giant pseudo SAA. A 65-year-old female patient with a pancreatic mass and iron deficiency was referred to our clinic for further investigation. Abdominal ultrasonography, contrast-enhanced CT and magnetic resonance imaging showed a lesion resembling a subcapsular hemangioma in the spleen, and aneurysmatic dilation of the splenic artery with a diameter of >5 cm. The large size of the aneurysm and the clinical findings were indications for surgical treatment. The patient underwent en bloc resection of the spleen, distal pancreas, and aneurysmatic segment of the splenic artery. The patient remains complication-free 2 months after the operation. Spontaneous rupture is the most important life-threatening complications of giant SAAs. Therefore, all symptomatic patients with SAA should be treated, as well as asymptomatic patients with lesions ≥2 cm, who are pregnant or fertile, have portal hypertension, or are candidates for liver transplantation. Despite advances in endovascular techniques, conventional abdominal surgery remains the gold standard for treatment.
authors.affiliation: 1 Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yagmur
authors.affiliation: 2 Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Akbulut
authors.affiliation: 1 Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Gumus
authors.affiliation: 1 Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Demircan
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010179:Pancreas / Q000000981:diagnostic imaging / Q000601:surgery; D013156:Splenectomy; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Chronic pancreatitis; Giant splenic artery aneurysm; Open surgery; Splenic artery aneurysms