Presentation
Non-specific abdominal pain. No medical or surgical history.
Patient Data
The spleen appears average in size displaying normal homogeneous CT density. No evidence of splenic masses or cysts were detected.
The pancreas appears average in size displaying normal CT density. There is a well-defined rounded peripherally calcified lesion within the tail of the pancreas, which shows contrast opacification parallel to the splenic artery and appears connected to it, in keeping with a splenic artery aneurysm, measures about 2 x 1.5 cm.
No abdominal aortic or another visceral arterial aneurysm.
Case Discussion
A splenic artery aneurysm is the commonest visceral arterial aneurysm and the third most common abdominal aneurysm after the aorta and iliac vessels.
Most aneurysms are true aneurysms and saccular in shape.
A large proportion of splenic artery aneurysms are discovered incidentally as they are asymptomatic in the majority of cases, unless complicated. Wider use of cross-sectional imaging for other reasons increases the diagnosis.
Splenic artery aneurysms are more common in females but rupture more common in males.
Causes include atherosclerosis, fibromuscular dysplasia, trauma, vasculitis, and pregnancy-related.
Most aneurysms are less than 3 cm with peripheral calcification.
The risk of rupture depends on size, less than 2 cm follow up, while more than 2 cm requires endovascular therapy.