Pasha Shabana F, Gloviczki Peter, Stanson Anthony W, Kamath Patrick S
Division of General Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN 55905 USA.
Mayo Clin Proc. 2007 Apr;82(4):472-9. doi: 10.4065/82.4.472.
Autopsy studies suggest that splanchnic artery aneurysms may be more frequent than abdominal aortic aneurysms. These aneurysms are important to recognize because up to 25% may be complicated by rupture, and the mortality rate after rupture is between 25% and 70%. However, little is known about the natural history and clinical presentation of splanchnic artery aneurysms. Splenic artery aneurysms are the most common of the splanchnic artery aneurysms; multiple aneurysms are present in approximately one third of patients. Hepatic artery pseudoaneurysms are more common than true aneurysms because of increasing numbers of hepatobiliary interventional procedures. The diagnosis of splanchnic artery aneurysm should be considered in any patient with abdominal pain, a pulsatile mass, or an abdominal bruit with or without associated bleeding. However, most aneurysms are asymptomatic and are detected incidentally on imaging studies. Treatment, which can be either surgical or interventional radiology-based, should be considered in all patients with symptoms related to the aneurysms, if the aneurysm is more than 2 cm in diameter, if the patient is pregnant, or if there is demonstrated growth of the aneurysm.
尸检研究表明，内脏动脉瘤可能比腹主动脉瘤更为常见。认识到这些动脉瘤很重要，因为高达25%的动脉瘤可能并发破裂，破裂后的死亡率在25%至70%之间。然而，对于内脏动脉瘤的自然病史和临床表现知之甚少。脾动脉瘤是最常见的内脏动脉瘤；约三分之一的患者存在多发性动脉瘤。由于肝胆介入手术数量的增加，肝动脉假性动脉瘤比真性动脉瘤更为常见。任何出现腹痛、搏动性肿块或腹部杂音（无论有无相关出血）的患者都应考虑内脏动脉瘤的诊断。然而，大多数动脉瘤是无症状的，在影像学检查中偶然发现。对于所有出现与动脉瘤相关症状的患者、动脉瘤直径超过2厘米的患者、孕妇或已证实动脉瘤有生长的患者，都应考虑进行手术或基于介入放射学的治疗。
