Journal
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
Volume 8, Issue 4, Pages 223-231Publisher
ROYAL COLLEGE SURGEONS EDINBURGH
DOI: 10.1016/j.surge.2009.11.011
Keywords
Splenic artery aneurysm; False splenic artery aneurysm; Conservative treatment; Pregnancy; Portal hypertension
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Splenic artery aneurysm is the third most common intra-abdominal aneurysm with a prevalence as high as 10% in some studies. Widespread use of abdominal imaging has resulted in the increasing detection of asymptomatic incidental aneurysms. In this manuscript we review the changing incidence, risk factors and evolving therapeutic options in the era of minimally invasive therapy and have developed a treatment algorithm for practical use. Aneurysms with a low risk of rupture may be treated conservatively but require regular imaging to ascertain progress. Available evidence suggests that splenic artery aneurysms that are symptomatic, enlarging, more than 2 cm in diameter or those detected in pregnancy, childbearing age or following liver transplantation are at high risk of rupture and should undergo active treatment. Prophylactic screening should be reserved for those with multiple risk factors, such as pregnancy in liver transplant recipients. All false aneurysms should also be treated. The primary therapeutic approach should be endovascular therapy by either embolization or stent grafting. Crown Copyright (C) 2009 Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.
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