Aneurisma de la arteria esplénica con fistulización arteriovenosa

TRADUCCIÓN
Resumen(en)

Visceral aneurysms represent a small fraction in abdominal vascular disease. However, it is necessary to take them into account because the risk to life implied by their possibility of rupture and bleeding.

The splenic artery aneurysms are rare. Female sex, hypertension with splenomegaly, arteriosclerosis, pregnancy, infections and trauma are considered to be pathogenetic factors for their appearance.

The existence of splenic artery aneurysms in association with pregnancy, liver transplantation, lupus erythematosus and coagulopathy has been reported. Rupture is often the first and only symptom.

Their average size is usually 3 cm and the risk of rupture is higher when they are larger than 2 cm.

Complications include gastrointestinal bleeding and hemoperitoneum.

They are difficult to diagnose because of their clinical manifestations so different imaging studies are needed. Treatment is always surgical.

We describe here the case of a 24 year old patient with thrombocytopenia referred to the Gastrointestinal Clinic due to the existence of serpiginous vascular structures dilated at the splenic hilum and intrahepatic portal hypertension.

The patient was diagnosed with splenic artery aneurysm with arteriovenous fistula signs and she underwent a subcostal splenectomy with pre-aneurysm ligation of the splenic artery as the treatment of choice.