What are the symptoms and treatments for splenic artery aneurysm?

What are the symptoms of splenic artery aneurysm? What are the treatments?

What are the symptoms of splenic artery aneurysm?

1. Symptoms of splenic artery aneurysm may include upper abdominal pain, paroxysmal colic, nausea, vomiting, splenomegaly, and even intestinal obstruction; about 10% of cases can be palpated with a mass, and 6% have a pulsating sensation and cat wheezing. However, most cases may not have obvious symptoms until the aneurysm ruptures into the stomach, intestines, or abdominal cavity, and the diagnosis is not made until surgical exploration. Less than 10% of cases are correctly diagnosed before rupture.

2. Symptoms after rupture include severe pain in the upper abdomen, radiating pain in the left shoulder, Kehr's sign, and tenderness in the abdominal wall below the left costal margin, accompanied by nausea, vomiting, and other bleeding symptoms. Splenic artery aneurysm can also form an internal fistula with the portal vein system, causing ascites, hepatosplenomegaly, and other manifestations of portal hypertension.

What are the treatments?

1. The surgical procedure for splenic artery aneurysm depends on the location of the aneurysm. If the aneurysm is far away from the splenic hilum, at the beginning of the splenic artery, simple proximal and distal artery ligation of the aneurysm or aneurysm resection and splenic artery reconstruction can be performed to preserve the spleen.

2. If the tumor is close to the splenic hilum, splenic artery aneurysm and splenectomy should be performed. If the aneurysm is located in the middle and distal segments of the splenic artery and is closely related to the pancreas and splenic vein, the proximal and distal arteries of the tumor can be simply ligated to block their blood supply, and the tumor does not need to be forcibly removed. If the tumor is tightly adhered to the pancreatic body and tail, it is difficult to ligate the proximal and distal arteries, and forced separation is likely to cause heavy bleeding. Combined resection of the aneurysm, pancreatic body and tail, and spleen can be considered.

3. If there is an internal fistula between the splenic artery aneurysm and the portal vein, it should be cut open after blocking the blood supply to the aneurysm, and the fistula should be repaired before the aneurysm is removed. In addition to treating the aneurysm, complications of portal hypertension should also be treated, such as portal vein disconnection.