Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010000400009
Jornal Vascular Brasileiro
Case Report

Aneurisma de artéria esplênica corrigido por embolização com molas

Splenic artery aneurysm treated by coil embolization

Rafaele Maria Araújo de Sena Pino; Eduardo Alexandre Souza Gois; Larissa Gouveia Aragão; Ângelo Mário de Sá Bomfim Filho; David Campos Wanderley

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Resumo

O aneurisma da artéria esplênica é uma entidade clínica rara, embora seja o mais frequente entre os aneurismas viscerais, sendo encontrado em 0,8% da população. Apresenta-se mais frequentemente em mulheres, na proporção de 4:1, e raramente provoca sintomas ou sinais clínicos. Desenvolve-se de forma assintomática e, na maioria dos casos, é diagnosticado por meio de exames indicados para elucidar queixas clínicas decorrentes de outras doenças ou quando apresenta complicações por vezes fatais, como a rotura. A possibilidade de rotura dos aneurismas de artéria esplênica com diâmetro inferior a 2 cm é baixa; entretanto, os que apresentam diâmetro igual ou maior que 3 cm são usualmente encaminhados para tratamento cirúrgico, devido ao alto risco de rotura. O tratamento eletivo é indicado nos casos não complicados, sendo a embolização com molas um método interessante por evitar o tratamento cirúrgico convencional.

Palavras-chave

Artéria esplênica, doenças vasculares, embolização terapêutica

Abstract

The splenic artery aneurysm is an uncommon clinical entity, but is the most frequent among visceral aneurysms and is present in 0.8% of the population. It is more common in women, with a ratio of 4:1, and rarely causes symptoms or signs. It develops asymptomatically and, in most cases, is diagnosed by tests indicated to elucidate clinical complaints subsequent to other diseases or when there are fatal complications such as rupture. The possibility of rupture of splenic artery aneurysms with a diameter less than 2 cm is low; however, those with a diameter equal to or greater than 3 cm are usually referred for surgical treatment due to the high risk of rupture. The elective treatment is indicated for non complicated cases, and the coil embolization is an interesting method, since it avoids conventional surgical treatment.

Keywords

Splenic artery, vascular diseases, embolization

References

Spencer Netto FAC, Damasceno F, Alencar CRP. Aneurisma roto de artéria esplênica: flagrante tomográfico de sangramento. Rev Col Bras Cir.. 2002;29:119-21.

Trastek VF, Pairolero PC, Joyce JW, Hollier LH, Bernatz PE. Splenic artery aneurysms. Surgery. 1982;91:694-9.

van Berge Henegouwen DP. Aneurysms of intestinal arteries. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir.. 1990:341-6.

Mattar SG, Lumsden AB. The management of splenic artery aneurysms: experience with 23 cases. Am J Surg.. 1995;169:580-4.

de Perrot M, Bühler L, Deléaval J, Borisch B, Mentha G, Morel P. Management of true neurysms of splenic artery. Am J Surg.. 1998;175:466-8.

Wagner WH, Alexander AD, Treiman RL. Ruptured visceral artery aneurysms. Ann Vasc Surg.. 1997;11:342-7.

Evans GH, Gunn J, Castleden WM. Spontaneous rupture of a splenic artery aneurysm. Aust N Z J Surg.. 1992;62:664-5.

Fischer M. Ruptured aneurysm of the lienalis artery as a cause of acute abdomen: Case report and review of the literature. Helv Chir Acta.. 1991;58:359-63.

Seiler C, Blumgart LH. Gastrointestinal hemorrhage due to splenic artery aneurysm pancreatic duct fistula in chronic pancratitis: A case report and review of the literature. HPB Surg.. 1993;7:149-55.

Wagner WH, Cossman DV, Treiman RL, Foran RF, Levin PM, Cohen JL. Hemosuccus pancreaticus from intraductal rupture of a primary splenic artery aneurysm. J Vasc Surg.. 1994;19:158-64.

Angelakis EJ, Bair WE, Barone JE, Lincer RM. Splenic artery aneurysm rupture during pregnancy. Obstet Gynecol Surv.. 1993;48:145-8.

Caillouette JC, Merchant EB. Ruptured splenic artery aneurysm in pregnancy: Twelfth reported case with maternal and fetal survival. Am J Obstet Gynecol.. 1993;168:1810-1.

Hong GS, Wong CY, Nambiar R. Massive lower gastrointestinal hemorrhage from a splenic artery pseudoaneurysm. Br J Surg.. 1992;79:174.

Zelenock GB, Stanley JC. Splachnic artery aneurysms. Vascular surgery. 2000:1369-82.

Larson PA, Lipchik EO, Adams MB. Development and regression of visceral artery aneurysms following liver transplantation: case report. Cardiovasc Intervent Radiol.. 1988;11:75-8.

Miranda Júnior F. Aneurismas vicerais e periféricos. Angiologia e cirurgia vascular: guia ilustrado. 2003:1-10.

Smith JA, Macleish DG, Collier NA. Aneurysms of the visceral arteries. Aust N Z J Surg.. 1989;59:329-34.

Salam TA, Lumsden AB, Martin LG, Smith RB. 3rd. Nonoperative management of visceral aneurysms and pseudoaneurysms. Am J Surg.. 1992;164:215-9.

Guillaumon AT, Chaim EA. Splenic artery aneurysm associated with anatomic variations in origin. J Vasc Bras.. 2009;8:177-81.

Mandolfino T, Canciglia A, D'Alfonso M. Aneurismi dell'arteria splenica: Nostra esperienza. Chirurgia Italiana.. 2009;61:315-9.

Halloul Z, Meyer F, Grote R, Lippert H, Buerger T. Selective embolization of splenic artery aneurysm - case report. Eur Surg.. 2005;37:59-62.

Larraín D, Fava M, Espinoza R. Aneurisma de la arteria esplénica: Diagnóstico diferencial y alternativas terapéuticas. Rev Méd Chile. 2005;133:943-6.

Tochii M, Ogino H, Sasaki H. Successful surgical treatment for aneurysm of splenic artery with anomalous origin. Ann Thorac Cardiovasc Surg.. 2005;11:346-9.

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