Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.20230108
Jornal Vascular Brasileiro
Relato de Caso

Giant splenic artery aneurysm: case report

Aneurisma gigante da artéria esplênica: relato de caso

Aleksey Vasilyevich Shabunin; Vladimir Vladimirovich Bedin; Mikhail Mikhailovich Tavobilov; Аleksey Andreevich Karpov; Fariza Fayzulloevna Alieva

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Abstract

True splenic artery aneurysms are exceedingly rare and the medical literature contains only a limited number of reports on this pathology. Presently, there remains a lack of consensus regarding the optimal management and treatment approaches for patients in this category. Over the course of the last century, significant changes have occurred in the realm of surgical options, transitioning from open and endovascular procedures to the more advanced laparoscopic and robotic interventions. The propensity for these aneurysms to rupture underscores the need for timely intervention. The risk of rupture is notably elevated in patients harboring giant splenic artery aneurysms. In this report, we present the case of a 55-year-old woman diagnosed with a giant splenic artery aneurysm measuring 12x12 cm in diameter. She presented with notable weakness, discomfort, and pain in the left subcostal area. In response to her complaints and after thorough evaluation, we opted for a surgical procedure encompassing distal pancreatic resection in conjunction with splenectomy and resection of the giant splenic artery aneurysm.

Keywords

giant splenic artery aneurysm, aneurysm management, aneurysm resection, splenectomy, distal pancreatic resection, splenic artery intervention, vascular surgery

Resumo

Os aneurismas verdadeiros da artéria esplênica são extremamente raros, e há um número limitado de relatos sobre essa condição na literatura médica. Atualmente, não há consenso sobre as abordagens ideais de manejo e tratamento para pacientes que se enquadram nessa categoria. Ao longo do século passado, ocorreram mudanças significativas no domínio das opções cirúrgicas, passando de procedimentos abertos e endovasculares para intervenções laparoscópicas e robóticas mais avançadas. A propensão à ruptura do aneurisma ressalta a necessidade de intervenção em tempo oportuno. O risco de ruptura é notavelmente elevado em pacientes com aneurismas gigantes da artéria esplênica. Neste relato, apresentamos o caso de uma mulher de 55 anos diagnosticada com aneurisma gigante de artéria esplênica medindo 12x12 cm de diâmetro. A paciente apresentava fraqueza notável, desconforto e dor na região subcostal esquerda. Em resposta às suas queixas e após avaliação minuciosa, optamos por um procedimento cirúrgico que incluiu pancreatectomia distal associada a esplenectomia e ressecção do aneurisma gigante da artéria esplênica.

Palavras-chave

aneurisma gigante da artéria esplênica, manejo de aneurismas, ressecção de aneurisma, esplenectomia, pancreatectomia distal, intervenção na artéria esplênica, cirurgia vascular

Referências

1 Hussain K, Ibrahim T, Masood J. Giant splenic artery aneurysm. J Coll Physicians Surg Pak. 2015;25(1):83-4. PMid:25604380.

2 Salimi J, Omrani Z, Cheraghali R. Splenic artery aneurysm, case series of seven patients. J Surg Case Rep. 2021;2021(3):rjab046. http://dx.doi.org/10.1093/jscr/rjab046. PMid:33796259.

3 Yoshikawa C, Yamato I, Nakata Y, et al. Giant splenic artery aneurysm rupture into the stomach that was successfully managed with emergency distal pancreatectomy. Surg Case Rep. 2022;8(1):148. http://dx.doi.org/10.1186/s40792-022-01498-3. PMid:35915344.

4 Akbulut S, Otan E. Management of giant splenic artery aneurysm: comprehensive literature review. Medicine. 2015;94(27):e1016. http://dx.doi.org/10.1097/MD.0000000000001016. PMid:26166071.

5 Kauffman P, Macedo ALV, Sacilotto R, et al. The therapeutic challenge of giant splenic artery aneurysm: a case repport. Einstein (São Paulo). 2017;15(3):359-62. http://dx.doi.org/10.1590/s1679-45082017rc3873. PMid:28746591.

6 Pescarus R, Montreuil B, Bendavid Y. Giant splenic artery aneurysms: case report and review of the literature. J Vasc Surg. 2005;42(2):344-7. http://dx.doi.org/10.1016/j.jvs.2005.04.026. PMid:16102637.

7 Ho MF, Chan YC, Cheng SW. Successful endovascular management of giant splenic artery aneurysms. Vascular. 2013;21(5):317-22. http://dx.doi.org/10.1177/1708538113478744. PMid:23493275.

8 Rebelo A, Ronellenfitsch U, Partsakhaschwilli J, Kleeff J, John E, Ukkat J. Endovascular and open repair of visceral aneurysms: a retrospective single-center analysis. Exp Ther Med. 2023;25(6):252. http://dx.doi.org/10.3892/etm.2023.11951. PMid:37153884.

9 Shabunin AV, Bedin VV, Tavobilov MM, et al. Selecting the most appropriate surgical treatment of true splenic artery aneurysm. Khirurgiia (Mosk). 2022;(10):21-7. http://dx.doi.org/10.17116/hirurgia202210121. PMid:36223146.

10 Miao YD, Ye B. Intragastric rupture of splenic artery aneurysms: three case reports and literature review. Pak J Med Sci. 2013;29(2):656-9. PMid:24353598.

11 Ali S, Verma V, R S, Wani I. Giant splenic artery aneurysm: case report. ISRN Surg. 2011;2011:383450. http://dx.doi.org/10.5402/2011/383450. PMid:22084756.

12 Kalipatnapu S, Kota AA, Agarwal S. Giant splenic artery aneurysm. J Vasc Surg. 2019;69(6):1940. http://dx.doi.org/10.1016/j.jvs.2019.02.039. PMid:31159988.

13 Panzera F, Inchingolo R, Rizzi M, et al. Giant splenic artery aneurysm presenting with massive upper gastrointestinal bleeding: a case report and review of literature. World J Gastroenterol. 2020;26(22):3110-7. http://dx.doi.org/10.3748/wjg.v26.i22.3110. PMid:32587452.

14 Wernheden E, Brenøe AS, Shahidi S. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm. J Vasc Surg Cases Innov Tech. 2017;3(4):240-2. http://dx.doi.org/10.1016/j.jvscit.2017.10.008. PMid:29349435.

15 Herskowitz MM, Safriel Y, Gillego V. Successful treatment of a giant splenic artery aneurysm solely by proximal coil embolisation. EJVES Extra. 2002;3(3):52-3. http://dx.doi.org/10.1053/ejvx.2002.0138.
 


Submetido em:
04/07/2023

Aceito em:
28/09/2023

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