Splenic arteriovenous fistula formation due to angiodysplasia in a splenic aneurysm of a patient with liver cirrhosis--a report of a case.

A 53 year-old Japanese woman with liver cirrhosis manifested massive hematemesis due to ruptured esophageal varices. Celiac angiography demonstrated an aneurysm of the splenic hilus and arteriovenous fistula around the aneurysm. She underwent splenectomy, proximal gastrectomy, distal esophageal devascularization and pyloroplasty. Histological examination of the aneurysm revealed arterial dysplasia with a focal medial gap. Microscopic tissue clefts at the site of a medial gap were considered to be the source of the angiographic arteriovenous fistula.