CASE 12031 Published on 15.07.2014

Unusual cause of abdominal pain: Splenic artery aneurysm

Section

Abdominal imaging

Case Type

Clinical Cases

Authors

Lamhamedi S, Eddarei M, El Fenni J, Amil T, Hanine A

Lamfadel Cherkaoui
10000 Rabat, Morocco;
Email:dr.l.safae@hotmail.com
Patient

74 years, male

Categories
Area of Interest Abdomen ; Imaging Technique CT
Clinical History
A 74-year-old man with no medical history was admitted to the ED for intermittent abdominal pain in the epigastric and periumbilical regions without any other associated symptoms.
The physical examination was normal.
Imaging Findings
CT with intravenous injection and 3D reconstruction showed the splenic artery aneurysm.
Discussion
Splenic artery aneurysm (SAA) has an incidence rate of 0.7% in the normal population and is a rare cause of abdominal pain. [1]
SAA are most commonly associated with pregnancy, portal hypertension, atherosclerosis and variable congenital diseases. [2]
SAA are difficult to diagnosis due to their variable clinical manifestations: up to 80% of patients with SAA are asymptomatic. [3] However, SAA can be complicated with rupture into the abdominal cavity or another organ such as the stomach. [2, 3]
CT with injection of intravenous contrast material is the most common diagnostic test due to its availability to show an addition structure near the splenic artery presenting the same enhancement of the aorta [1], but ultrasound can be particularly useful for the pregnant patient. [2]
In our case there was no proof that the SAA was the cause of the patient’s symptoms, however, no other lesions was found in the examination.
The goal of treatment of these aneurysms is to prevent rupture, while maintaining the blood flow. Therefore, the resection of the aneurysm and the reconstruction of the splenic artery by surgery remain the gold standard for fulfilling these goals. [4]
Differential Diagnosis List
Splenic artery aneurysm
Epidermoid cyst
Hydatid cyst
Final Diagnosis
Splenic artery aneurysm
Case information
URL: https://www.eurorad.org/case/12031
DOI: 10.1594/EURORAD/CASE.12031
ISSN: 1563-4086