Large splenic artery aneurysm
Referred with an epigastric mass and jaundice. Suspected choledochal cyst. No significant past medical history
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Large epigastric and left-sided irregular cystic mass, with swirling flow within. With Doppler the bidirectional flow within the cystic mass was producing the well-known yin-yang sign consistent with an aneurysm/pseudoaneurysm.
This patient was scheduled for surgery the very next day. in the afternoon of the same day, the aneurysm ruptured and the patient was resuscitated and taken to theater and splenic artery aneurysm was confirmed and repaired.
The cause of the aneurysm is still unclear. There was no history of pancreatitis or chronic disease/infection. In the end, it was considered to be a congenital aneurysm. Congenital splenic aneurysms are rare and they usually present in elderly women.