Correia de Sá Tiago, Soares Carlos, Queirós Jacinta, Rocha Teresa Mónica, Oliveira Manuel
General Surgery Department, Centro Hospitalar Tâmega e Sousa, Avenida do Hospital Padre Américo, No. 210, 4560-136 Guilhufe Penafiel, Portugal.
Case Rep Surg. 2020 Jan 20;2020:2873560. doi: 10.1155/2020/2873560. eCollection 2020.
. Splenic artery aneurisms (SAA) are the third most common aneurysms, with reported incidences up to 10.4%. There is a higher prevalence in women, and most are incidental findings on imaging studies. Symptomatic or SAA larger than 20 mm and aneurysms in pregnant or in women of childbearing age are indications for surgery, because of the increased risk of rupture. Treatment options include endovascular, laparoscopic, and open surgical approaches. . A 50-year-old female patient with nonspecific abdominal pain performed a computed tomography scan and angiography, which revealed a 24 × 20 × 19 mm SAA. After a multidisciplinary discussion, selective laparoscopic excision of the aneurysm was performed, with spleen preservation. Perioperative course was uneventful, and the patient remained asymptomatic. . A multidisciplinary discussion is of major importance in guaranteeing the optimal treatment for any given visceral aneurysm. Not all SAA are amenable to endovascular treatment, and laparoscopic surgery has mostly replaced open procedures. Laparoscopic ligation and resection of the SAA with splenic preservation offers permanent treatment, with a low morbidity and short hospital stay.
Selective laparoscopic aneurysm resection is a safe and effective approach, with good short- and long-term results, allowing permanent treatment of SAA while maintaining splenic function.
脾动脉瘤(SAA)是第三常见的动脉瘤,报告的发病率高达10.4%。女性患病率更高,大多数是影像学检查中的偶然发现。有症状的或直径大于20毫米的SAA以及妊娠或育龄期女性的动脉瘤是手术指征,因为破裂风险增加。治疗选择包括血管内、腹腔镜和开放手术方法。一名50岁有非特异性腹痛的女性患者进行了计算机断层扫描和血管造影,结果显示一个24×20×19毫米的SAA。经过多学科讨论后,进行了选择性腹腔镜下动脉瘤切除术,并保留脾脏。围手术期过程顺利,患者仍无症状。多学科讨论对于确保任何特定内脏动脉瘤的最佳治疗至关重要。并非所有SAA都适合血管内治疗,腹腔镜手术大多已取代开放手术。腹腔镜下结扎和切除SAA并保留脾脏可提供永久性治疗,发病率低且住院时间短。
选择性腹腔镜动脉瘤切除术是一种安全有效的方法,短期和长期效果良好,能够在维持脾功能的同时对SAA进行永久性治疗。