Yadav Rajkumar, Tiwari Manish Kumar, Mathur Rajendra Mohan, Verma Ajay Kumar
Department of C.T.V.S., S.M.S. Medical College and Hospital, Rajasthan, India.
Interact Cardiovasc Thorac Surg. 2009 Mar;8(3):384-6. doi: 10.1510/icvts.2008.196121. Epub 2008 Dec 16.
Although splenic artery aneurysm (SAA) is the commonest visceral and third most common intra abdominal aneurysm after aorta and iliac artery, aneurysm of splenic artery along with aneurysm of splenic vein with arteriovenous (a-v) fistula communication between them is a rare entity. Most are <3 cm in diameter. Giant true SAAs are rare and very few lesions >10 cm have been reported. We hereby report a case of an 18 cm x 15 cm size splenic artery and vein aneurysm with a-v fistula in an adult female nulliparous woman who presented with progressively enlarging pulsatile mass in the left upper abdomen with long-standing intractable pancytopenia and splenomegaly. Diagnosis was established by CT (computed tomogram) angiogram and laboratory tests. Laparotomy demonstrated huge well-defined aneurysm of splenic artery and vein with splenic a-v fistula, extending in all except the right lower and inferior quadrants of the abdomen along with splenomegaly. Aneurysmectomy with splenectomy was done.
尽管脾动脉瘤（SAA）是最常见的内脏动脉瘤，也是仅次于主动脉和髂动脉的第三大常见腹内动脉瘤，但脾动脉动脉瘤以及伴有脾动静脉瘘的脾静脉动脉瘤是一种罕见的情况。大多数脾动脉瘤直径小于3厘米。巨大真性脾动脉瘤很少见，报道的直径大于10厘米的病变非常少。我们在此报告一例成年未育女性，其脾动脉和静脉动脉瘤大小为18厘米×15厘米，伴有动静脉瘘，表现为左上腹搏动性肿块逐渐增大，伴有长期难治性全血细胞减少和脾肿大。通过CT（计算机断层扫描）血管造影和实验室检查确诊。剖腹手术显示脾动脉和静脉有巨大的边界清晰的动脉瘤，伴有脾动静脉瘘，除腹部右下腹和下象限外均有延伸，同时伴有脾肿大。进行了动脉瘤切除术和脾切除术。
