Occurrence of large proximal splenic artery aneurysms in chronic liver disease.

Two cases are reported of large pre-splenic aneurysms of the splenic artery in patients with chronic liver disease, and three others cited from the literature. Four of the five died from rupture of the aneurysm. All patients were parous females with chronic liver disease, and in four of the five this was known to be present before pregnancy. It is suggested that proximal splenic artery aneurysms in such patients are due to both haemodynamic changes of portal hypertension and the endocrine changes of pregnancy. This concept may lead to early recognition of these lesions, although there are as yet no certain indications for investigation or surgical intervention in asymptomatic patients.