Schweckendiek Daniel, Lehmann Kuno, Van den Bosch Vincent
Department of Gastroenterology and Hepatology, University Hospital Zurich, Zürich, Switzerland.
Bürgerspital Solothurn, Department of Visceral Surgery, Solothurn, Switzerland.
Case Rep Gastroenterol. 2025 Jun 17;19(1):439-444. doi: 10.1159/000546314. eCollection 2025 Jan-Dec.
Splenic artery aneurysm (SAA) is a rare but potentially life-threatening condition. SAA can occur following an acute or chronic pancreatitis as a pseudoaneurysm, iatrogenic (post-pancreatic/splenic surgery) or post-traumatic. If symptomatic, it needs to be treated urgently as it has a high risk of rupture.
Here is a case where a ruptured aneurysm presented in an unusual manner: first as an acute abdomen and second, delayed, as hemorrhagic shock. Only emergency laparotomy and splenectomy saved the patient's life.
If a splenic artery pseudoaneurysm is detected on CT scan, there is an increased risk of rupture irrespective of the size and the patient that should be proactively managed. Concomitant abdominal findings and diseases can delay diagnosis and underestimate the risk.
脾动脉瘤(SAA)是一种罕见但可能危及生命的疾病。SAA可在急性或慢性胰腺炎后作为假性动脉瘤出现,也可由医源性因素(胰腺/脾脏手术后)或创伤后引起。如果出现症状,由于其破裂风险高,需要紧急治疗。
这里有一个以不寻常方式出现的破裂动脉瘤病例:首先表现为急腹症,其次延迟出现,表现为失血性休克。只有紧急剖腹手术和脾切除术挽救了患者的生命。
如果在CT扫描中检测到脾动脉假性动脉瘤,无论其大小如何,患者的破裂风险都会增加,应积极进行处理。同时存在的腹部体征和疾病可能会延迟诊断并低估风险。