de Vries J E, Schattenkerk M E, Malt R A
Surgery. 1982 Feb;91(2):200-4.
Thirty-eight patients with aneurysms of the splenic artery were identified in the records of 11 years, but only one aneurysm was ruptured. Portal hypertension was found in nine patients (24%); in two of these the reaction surrounding the aneurysm prevented the construction of a patent splenorenal shunt or caused compartmented portal hypertension. One aneurysm encountered during the survey period and another encountered just after its conclusion ruptured into the stomach. There was a twofold overrepresentation of multiparous women. Intraperitoneal rupture is rare, except in pregnancy. If elective therapy is considered, angiography should be performed. Exclusion or resection of the aneurysm is advocated only for patients with symptomatic or ruptured aneurysms or (very rare) large aneurysms and for women of childbearing age. The spleen should be preserved, when possible. In high-risk patients occlusion of the aneurysm via an intra-arterial catheter should be considered. If the splenic artery aneurysm causes compartmented portal hypertension, splenectomy is indicated; if portal hypertension is general, the form of portasystemic decompression chosen should avoid the region of the aneurysm.
在11年的记录中，共发现38例脾动脉瘤患者，但只有1例动脉瘤破裂。9例患者（24%）存在门静脉高压；其中2例患者动脉瘤周围的反应妨碍了脾肾分流术的构建或导致了节段性门静脉高压。在调查期间发现的1例动脉瘤以及调查结束后不久发现的另1例动脉瘤破裂入胃。经产妇的比例高出两倍。除妊娠外，腹腔内破裂很少见。如果考虑进行择期治疗，应进行血管造影。仅对有症状或破裂的动脉瘤患者、（非常罕见的）大动脉瘤患者以及育龄期女性主张对动脉瘤进行排除或切除。尽可能保留脾脏。对于高危患者，应考虑通过动脉内导管闭塞动脉瘤。如果脾动脉瘤导致节段性门静脉高压，则应行脾切除术；如果门静脉高压是全身性的，则所选择的门体分流减压形式应避开动脉瘤区域。
