Shimoda Mitsugi, Kubota K, Sakuma A, Hogami T, Yamaguchi H, Tagaya N
Department of Gastroenterological Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
J Gastrointest Surg. 2003 Jul-Aug;7(5):683-6. doi: 10.1016/s1091-255x(03)00028-3.
Splenic vein aneurysm (SVA) is extremely rare. Most patients with an SVA have portal hypertension. In this report we describe the first recorded case of intra-abdominal hemorrhage due to rupture of an SVA in a patient without evidence of portal hypertension. A 72-year-old man was admitted to our medical center in a state of shock, with complaints of acute abdominal pain and abdominal distention. Preoperatively, abdominal ultrasonography demonstrated an echo-free space in the abdomen, suggesting the presence of a fluid collection. In addition, computed tomography revealed an enhanced lesion with contrast material in the pancreatic tail. An emergency operation showed bleeding from the SVA near the pancreatic tail. Consequently, a distal pancreatectomy with splenectomy was performed. Histologically the lesion was diagnosed as an SVA surrounded by pancreatic tissue with chronic inflammatory changes. The patient's postoperative course was uneventful.
脾静脉动脉瘤（SVA）极为罕见。大多数脾静脉动脉瘤患者患有门静脉高压症。在本报告中，我们描述了首例无门静脉高压证据的患者因脾静脉动脉瘤破裂导致腹腔内出血的病例。一名72岁男性因休克状态入住我们的医疗中心，主诉急性腹痛和腹胀。术前，腹部超声显示腹部有一无回声区，提示有液体积聚。此外，计算机断层扫描显示胰尾有一增强病变伴造影剂。急诊手术显示胰尾附近的脾静脉动脉瘤出血。因此，实施了远端胰腺切除术加脾切除术。组织学检查病变被诊断为被慢性炎症改变的胰腺组织包绕的脾静脉动脉瘤。患者术后恢复顺利。
