Giant splenic artery aneurysm: case report / Aneurisma gigante da artéria esplênica: relato de caso

Abstract True splenic artery aneurysms are exceedingly rare and the medical literature contains only a limited number of reports on this pathology. Presently, there remains a lack of consensus regarding the optimal management and treatment approaches for patients in this category. Over the course of the last century, significant changes have occurred in the realm of surgical options, transitioning from open and endovascular procedures to the more advanced laparoscopic and robotic interventions. The propensity for these aneurysms to rupture underscores the need for timely intervention. The risk of rupture is notably elevated in patients harboring giant splenic artery aneurysms. In this report, we present the case of a 55-year-old woman diagnosed with a giant splenic artery aneurysm measuring 12x12 cm in diameter. She presented with notable weakness, discomfort, and pain in the left subcostal area. In response to her complaints and after thorough evaluation, we opted for a surgical procedure encompassing distal pancreatic resection in conjunction with splenectomy and resection of the giant splenic artery aneurysm.

Resumo Os aneurismas verdadeiros da artéria esplênica são extremamente raros, e há um número limitado de relatos sobre essa condição na literatura médica. Atualmente, não há consenso sobre as abordagens ideais de manejo e tratamento para pacientes que se enquadram nessa categoria. Ao longo do século passado, ocorreram mudanças significativas no domínio das opções cirúrgicas, passando de procedimentos abertos e endovasculares para intervenções laparoscópicas e robóticas mais avançadas. A propensão à ruptura do aneurisma ressalta a necessidade de intervenção em tempo oportuno. O risco de ruptura é notavelmente elevado em pacientes com aneurismas gigantes da artéria esplênica. Neste relato, apresentamos o caso de uma mulher de 55 anos diagnosticada com aneurisma gigante de artéria esplênica medindo 12x12 cm de diâmetro. A paciente apresentava fraqueza notável, desconforto e dor na região subcostal esquerda. Em resposta às suas queixas e após avaliação minuciosa, optamos por um procedimento cirúrgico que incluiu pancreatectomia distal associada a esplenectomia e ressecção do aneurisma gigante da artéria esplênica.

Clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension complicated with splenic aneurysm / 中华消化外科杂志

Objective:To investigate the clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension com-plicated with splenic aneurysm.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with portal hypertension complicated with splenic aneurysm who were admitted to 2 medical centers (15 cases in Shenzhen University General Hospital and 2 cases in Wuhan First Hospital) from January 2013 to May 2020 were collected. There were 7 males and 10 females, aged (59±14)years. All patients underwent totally laparoscopic exoclusion of splenic artery aneurysm combined with pericardial devascularization. Observation indicators : (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by out-patient examiantion and telephone interview to detect the effect of exclusion of arterial tumor, and blood re-flow, portal vein thrombosis and survival of patients 3 months after operation. The follow-up was up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Results:(1) Surgical and postoperative conditions. All 17 patients successfully completed the operation, without perioperative death. The operation time, volume of intraoperative blood loss of 17 patients were (181±30)minutes, 187(range, 90?420)mL. The white blood cell count, red blood cell count, hemoglobin, serum albumin were (9±4)×10 9/L, (3.5±0.9)×10 12/L, (86±17)g/L, (36±7)g/L on the postoperative day 3. Time to postoperative abdominal drainage tube removal and duration of post-operative hospital stay were (7±4)days and (11±4)days. (2) Complications. All 17 patients had ascites after surgery, which were improved after oral treatment with diuretics. There was no complication such as intra-abdominal hemorrhage, gastrointestinal fistula, pleural effusion, infection, abscess formation, fever and vascular embolism. (3) Follow-up. All the 17 patients were followed up for 28.6(range, 7.0?84.0)months. During the follow-up, the splenic aneurysm cavity of all patients was completely isolated, no blood re-flow and no portal vein thrombosis was observed, and no patient died. Conclusion:Totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization is safe and feasible in the treatment of portal hypertension complicated with splenic aneurysm.

Aneurisma gigante de la arteria esplénica: reporte de un caso / Giant splenic artery aneurysm: case report

Resumen Objetivo: Reportar el caso de un aneurisma gigante de la arteria esplénica de 9,5 cm de diámetro, en una mujer de 75 años de edad, que consultó por síndrome vertiginoso, con hallazgo incidental al examen físico de masa abdominal pulsátil, confirmado mediante angiotomografía de abdomen y pelvis. Materiales y Método: Registro clínico de una paciente sometida a reparación quirúrgica abierta de una aneurisma gigante de la arteria esplénica. Resultados: Mediante laparotomía, abordaje anterior, se efectúa la ligadura del aneurisma con resección parcial del saco aneurismático más esplenectomía, evolucionando sin complicación a 12 meses de seguimiento. Discusión: Se define como aneurisma de la arteria esplénica a toda dilatación mayor a 1 cm de diámetro, presenta indicación quirúrgica cuando mide más de 2 cm y se denomina gigante a partir de los 5 cm. Conclusión: Los aneurismas de la arteria esplénica son una condición infrecuente, habitualmente asintomática, pero potencialmente mortal especialmente en embarazadas; en la literatura solo existen 78 casos reportados de aneurismas gigantes de la arteria esplénica, se recomienda la resolución quirúrgica expedita.

Aim: To report the case of a giant splenic artery aneurysm of 9.5 cm diameter, in a 75 years old woman, who consulted for vertiginous syndrome, with incidental finding to the physical examination of pulsatile abdominal mass, confirmed by angiotomography of abdomen and pelvis. Materials and Method: Clinical record of a patient undergoing open surgical repair of a giant splenic aneurysm. Results: By laparotomy, anterior approach, the ligation of the aneurysm is performed with partial resection of the aneurysm sac plus splenectomy, evolving without complication at 12 months of follow-up. Discussion: The splenic artery aneurysm, is defined at any dilatation greater than 1 cm in diameter, it is surgically indicated when they measure more than 2 cm and called giant from 5 cm. Conclusion: Splenic artery aneurysm is a uncommon condition, usually asymptomatic, but potentially fatal especially in pregnant women, in the literature there are only 78 reported cases of giant splenic artery aneurysms, expedited surgical resolution is recommended.

Fatal spontaneous rupture of splenic artery aneurysm in third trimester pregnancy

@#Introduction: Unforeseen emergency in late pregnancy can be catastrophic and cause unexpected maternal and foetal demise. Moreover, lack of awareness and failure of prompt treatment raise mortality rate. Such fatalities warrant a forensic autopsy as it may raise redundant medico-legal concerns. Case Report: We report a case that revealed significant intra-abdominal haemorrhage at autopsy. The source of haemorrhage was at the spleen hilum and histology established rupture of splenic artery aneurysm. There was no associated obstetric cause found. Conclusion: Knowledge of spontaneous rupture of splenic artery aneurysm in late pregnancy is essential for monitoring maternal and foetal, morbidity and mortality. However, in the eventuality of death a comprehensive forensic autopsy is the only investigation to recognise such calamity and clear clinical confusion.

Recurrent Upper Gastrointestinal Hemorrhage due to Hemosuccus Pancreaticus from True Splenic Artery Aneurysm / 대한내과학회지

Hemosuccus pancreaticus, defined as bleeding from the papilla of Vater via the pancreatic duct, is a rare cause of recurrent upper gastrointestinal bleeding. We report the case of a 67-year-old man with recurrent gastrointestinal bleeding, who was subsequently diagnosed with hemosuccus pancreaticus caused by rupture of a true splenic artery aneurysm. The patient had chronic pancreatitis after considerable delay and unnecessary surgical small bowel exploration. The patient was cured with distal pancreatectomy because concomitant arcuate ligament syndrome precluded the angiographic approach via the celiac trunk, and tortuous dilatation of the distal pancreatic duct could not exclude the main duct type of intraductal papillary mucinous neoplasm (IPMN). In the surgical specimen, the pancreatic duct contained a hematoma and was lined by normal epithelium, indicating rupture of the splenic artery aneurysm that bled into the pancreatic duct.

CT manifestations of splenic artery aneurysm associated with liver cirrhosis and its clinical value / 实用放射学杂志

Objective To explore the CT manifestations of splenic artery aneurysm (SAA)in patients with liver cirrhosis,and its relationship with degree of cirrhosis.Methods SAA in 61 patients were confirmed from total 2 024 patients with liver cirrhosis but without hepatoma,and the clinic and CT data were retrospectively analyzed.Results SAA incidence rate of 3.0% (13.6% of women,1.5% of men,9.3% of portal hypertension and 10.2% of hypersplenotrophy)was observed in patients with liver cirrhosis. Multiple SAAs usually were showed with large round lesions (>1.0 cm)in the middle and distal segment of splenic artery and small fusiform ones (≤1.0 cm)in the branches of splenic artery (P =0.000).With the gradual deterioration of cirrhosis produce,the number and size of large aneurysms in proximal segment of splenic artery and number of small ones were increased with more inci-dence rates of calcification of aneurysm wall,haematoma of peri-aneurysm,mural thrombosis in SAA,megalosplenia/infarction of spleen and phlebeurysma (P =0.000).Conclusion Higher incidence rate of SAA in female patients with liver cirrhosis,portal hy-pertension and hypersplenotrophy is observed.CT can show well the location,number,size,shape and other features of SAA and portal hypertension,CT findings are correlated with the degree of cirrhosis,which may help for the treatment.

Case Report of Rupture of Splenic Artery Aneurysm during Pregnancy with Poor Outcomes.

Aims: To highlight the importance of considering non-obstetrical etiologies for acute abdominal pain in gravid patients with risk factors for vasculopathies including diabetes and hypertension. Specifically, we report a tragic case of splenic artery aneurysm (SAA) rupture during the third trimester in a diabetic patient resulting in maternal-fetal mortality. Traumatic vascular events during pregnancy may be associated with a high rate of maternal and fetal morbidity or mortality. Therefore early and rapid intervention is critical to the obstetrical outcome. Presentation of Case: A 35 year old multiparous hypertensive diabetic patient presented with acute abdominal pain at 33 weeks of gestation. The presumptive diagnosis was concealed placental abruption with diabetic ketoacidosis. Although nonobstetrical diagnoses were not initially considered, postmortem analysis revealed a nonobstetrical etiology of SAA rupture with catastrophic consequences for the patient and fetus. Discussion: The likelihood of aneurysm rupture of SAA is heightened due to vasculopathic medical comorbidities such as hypertension and diabetes. The vascular congestion of pregnancy increases flow through arteries, leading to increased likelihood of aneurysm rupture without warning or preceding symptoms. Preconception screening and imaging modalities to confirm splenic artery aneurysms and elective repair are also discussed. Early consideration and accurate identification of SAA rupture is critical to saving the lives of both mother and fetus. Conclusion: SAA rupture, in the differential diagnosis of acute abdominal pain in pregnancy, should be considered more likely in multiparous patients and in the presence of comorbidities such as diabetes and hypertension.

Correlative research of CT manifestation of splenic artery aneurysm associated with posthepatitic cirrhosis and operation approach / 局解手术学杂志

Objective To evaluate how to select operation procedures for different CT manifestation of splenic artery aneurysm ( SAA) with posthepatitic cirrhosis. Methods In 61 cases with SAA,the CT manifestation ( location,number,size,portal vein,varicose vein,proxi-mal splenorenal shunt and spleen changes) of SAA,clinical features of cases,and operation approach were were retrospectively analyzed. Re-sults 4 patients who have the primary tumors located in the distal splenic artery with diameter 1. 0~2. 0 cm,spleen kidney shunt and mega-losplenia were given aortic aneurysm exclusion and branch aneurysms embolism by stages. Amiong the 15 cases of tumors resection,splenecto-my and devascularization,there were 4 cases of the primary tumors located in the middle of splenic artery and 11 cases in the distal splenic artery. There were 15 cases whose diameter of the primary tumor were lager than 2. 0 cm and 13 cases whose diameter of the primary tumor were 1. 0~2. 0 cm. There were 4 cases of cavernous transformation of portal vein,5 cases of splenic and gastric varices,15 cases of esophage-al and gastric varices,4 cases of splenic and gastric venous shunt,15 cases of megalosplenia and 4 cases of splenic infarction. Tumors resec-tion and branch aneurysms embolism by stages were conducted in 7 cases. The primary tumors located in the proximal splenic artery occured in 7cases,and the diameter of the primary tumor were 1. 0~2. 0 cm occured in 7 cases. Esophageal and gastric varices occured in 2 cases and splenomegaly occured in 7 cases. And there were 4 cases whose diameter of the tumor were 1. 0~2. 0 cm were given tumor resection and re-construction of splenic artery and continuity, including 1 case of proximal splenic artery,2 cases of medial splenic artery and 1 case of distal splenic artery. Conclusion Operation procedures were confirmed by CT findings such as location,number,size,portal vein,varicose vein, proximal splenorenal shunt and spleen changes of SAA combined with age,gender,body mass index and history.

A Small Ruptured Splenic Artery Aneurysm Presenting as Anemia and Melena after Graft Replacement of an Abdominal Aortic Aneurysm / 日本心臓血管外科学会雑誌

The splenic artery is a common site of intraabdominal aneurysms. Very few patients present with symptoms before a splenic artery aneurysm ruptures. However, the symptoms vary depending on the type of aneurysm. Some patients present with hemodynamic shock, while others develop mild lumbago, anemia, or syncope. Thus, it is sometimes difficult to diagnose and treat ruptured splenic aneurysms. We report a rare case of rupture of a small splenic artery aneurysm, which remained undetected for 3 months after the appearance of the first symptoms, i.e., anemia and melena, despite conducting different examinations at our hospital. A 74-year-old man who underwent a graft replacement of an abdominal aortic aneurysm in 2006 complained of melena in May 2011. He was severely anemic, but presented with no other symptoms. A 16-mm-diameter splenic aneurysm was detected during a previous operation. The splenic artery aneurysm, as seen on computer tomography (CT) scans, showed no significant change in diameter for 5 years. The patient underwent upper and lower gastrointestinal endoscopy, capsule endoscopy, and enhanced CT at the Department of Gastroenterology to determine the site of the bleeding. However, the source of the bleeding was unclear. Finally, a diagnosis by elimination was made and the cause of the melena was identified as a ruptured splenic aneurysm. The splenic artery aneurysm was treated with coil embolization, and the patient's anemia was cured. The splenic artery aneurysm ruptured and bled into the pancreatic duct. The findings of this case suggest that a small splenic artery aneurysm rupture might not cause major symptoms like hemodynamic shock or large hematomas that can be identified on CT scans, but they may bleed into visceral organs. Therefore, interventions for the treatment of a non-symptomatic abdominal visceral artery aneurysm should be carried out promptly.

Giant splenic artery aneurysm

SYNOPSIS: Splenic artery aneurysm (SAA) is an extremely rare vascular pathology. They are clinically important because of their potential for life-threatening rupture. The pathogenesis is not completely understood and its cause remains unknown. The size of SAA rarely exceeds three centimeters and giant SAA (measuring more than 10 centimeters) are extremely rare. We present a case of SAA larger than 12 centimeters, discuss its management and provide relevant literature. To our knowledge, this is the biggest reported SAA and the first documented case of a giant SAA in the Philippines.CASE SUMMARY: A 58-year-old male with history of essential hypertension and remote history of abdominal trauma was admitted for pain and a pulsatile mass at epigastrium and left upper abdomen. Examination of the abdomen noted pulsatile, nontender, fairly delineated mass at the left hypochondrium, a bruit was appreciated in the area, Traube's space was dull and splenic percussion sign was negative. Laboratory tests showed normal CBC and bleeding parameters, mild azotemia (that improved after hydration) and unremar kable elect rocardiogramand echocardiogram results. A multislice computed tomography scan with contrast of the abdomen revealed 10.0 x 6.4 centimeters aneurysmal dilatation at the distal third of the splenic artery with intraluminal thrombus formation. The diagnosis was splenic artery aneurysm. Patient underwent splenic aneurysmectomy, splenectomy and di s tal pancreatectomy Gross examinat ion showed an unruptured 12.2x8.0x6.0 centime ters fusiform splenicarteryaneurysm. Histopathology showed hyal inization and focal destruction of aneurysmal wall and this confirmed the diagnosis. Eight months postoperatively, patient was in good health.CONCLUSION: Early diagnosis and prompt definitive treatment is necessary in its management. This can only be instituted if SAA is considered in the differential diagnosis for pulsatile left hypochondriac mass.

Transcatheter arterial embolization for the treatment of splenic artery aneurysms: clinical results in eight cases / 介入放射学杂志

Objective To assess the feasibility and effectiveness of transcatheter arterial embolization for the treatment of splenic artery aneurysms (SAAs). Methods Transcatheter splenic arterial embolization with coils was performed in eight cases of SAAs. The patients were followed for 3-36 months. The follow-up examinations with CT or color Doppler ultrasonic angiography were made. Results Technical success was achieved in all eight cases with no severe complications. During the follow-up period, one patient died of severe abdominal bleeding 10 months after the operation and the other seven patients remained in good condition with no occurrence of re-canalization of the lesions. Conclusion Transeatheter arterial embolization is a safe and effective treatment for splenic artery aneurysms. It is necessary to make a regular follow-up imaging study.

A Case of Splenic Artery Aneurysm Mimicking Gastric Submucosal Tumor / 대한소화기내시경학회지

Splenic artery aneurysm is an uncommon clinical entity. Most of these aneurysms are asymptomatic, but if an aneurysm ruptures, it can be fatal and its mortality rate reaches 70 percent. Regardless of the presence of symptoms, if the size of the asymptomatic aneurysm is larger than 2 cm in diameter or the patient is pregnant, then the anurysm should be treated. A 74-year-old female visited our hospital complaining of nonspecific epigastric discomfort. Endoscopic examination of the stomach revealed a submucosal tumor like protruding mass in the body and it was finally diagnosed as a splenic artery aneurysm by computed tomography. We report here on a case of a splenic artery aneurysm that mimicked a submucosal tumor, and this aneurysm was treated with surgery.

Large Splenic Artery Aneurysm with Abdominal Pain, Ascites, and Hematemesis

Splenic artery aneurysm (SAA) is an uncommon clinical entity. However, it is the most frequent aneurysmal disease of visceral arteries and the third most frequent among abdominal vessels. The cause of the disease and indications for surgical treatment are still controversial. In most cases, SAAs are detected as incidental findings. Their importance lies in potentially fatal consequence due to their rupture. SAAs occur predominantly in women and a majority of the patients with anuerysm are asymptomatic until rupture. Over the half of those, rupture occurs during pregnancy or in women who have had children. Rupture during pregnancy is associated with a very high maternal and fetal mortality rate. We experienced a case of 75-year-old female patient with large splenic artery aneurysm accompanying abdominal pain, ascites, and upper gastrointestinal bleeding. After this patient have had total splenectomy and aneurysmectomy, previous symptoms disappeared.

Splenic Artery Aneurysm associated with Chronic Pancreatitis due to Tuberculous Infection

Visceral artery aneurysms are rare, but potentially fatal, as they carry the risk of rupture and hemorrhage. Splenic artery aneurysms are the most common visceral artery aneurysm, with an occurrence rate of about 60%. Their risk of rupture has been estimated as between 2 and 10%, and the mortality rate due to a ruptured splenic artery aneurysm is significantly high, with reports of up to 25%. In most instances, an elective operation is recommended for low risk patients with a splenic artery aneurysm greater than 2 cm in diameter. Our patient had a 5x4x3 cm sized symptomatic splenic artery aneurysm and underwent an elective operation. However, during the operation, we unexpectedly found severely inflamed aneurysm embedded into the pancreatic tissue. The patient underwent proximal artery ligation and a distal pancreatectomy, including the affected artery, and a splenectomy. A histological examination of the pancreas revealed chronic granulomatous inflammation, with caseous necrosis, and the aneurysmal wall was dilated, with loss of elastic laminae. This report describes a rare case of a splenic artery aneurysm, with chronic pancreatitis due to a tuberculous infection as the predisposing factor.

Aneurisma roto de artéria esplênica: flagrante tomográfico de sangramento / Ruptured splenic artery aneurysm: tomographic snapshot of bleeding

The splenic artery aneurysm is a rare entity and its rupture is the most feared complication. The tomographic computed scan is a potential tool in the diagnosis, and can be used to patients with a suspicion of intra-abdominal bleeding, after adequate resuscitation. A case of a 68-year old male, hypertense patient, with a ruptured splenic artery aneurysm is reported. The diagnosis and treatment were given successfully by the abdominal computed tomographic scan and conventional surgery. The tomographic computed scan can be useful to the diagnosis of ruptured splenic artery aneurism, after the hemodynamic stabilization.

A Case of Spontaneous Rupture of a Splenic Artery Aneurysm in the Third Trimester / 대한산부인과학회잡지

The spontaneous rupture of splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two thirds of all ruptures happen during the third trimester. Clinical presentation is often non-specific, with good hemodynamic compensation, followed by a rapid deterioration. Active management and operation are the most important procedures for diagnosis and therapy of the bleeding. Abdominal delivery will help to establish diagnosis and should be performed immediately. We report a case of a patient at 38 weeks of gestation suffering epigastric pain and fetal distress. At emergency cesarean delivery, an aneurysmal rupture of the splenic artery was found to be the reason for the hemoperitoneum. Spleen, aneurysm and the tail of the pancreas were removed. In spite of fatal hemorrhage, the patient survived but her fetus was dead. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.

Hemosuccus Pancreaticus (Hemoductal Pancreatitis, Gastrointestinal Hemorrhage Due to Rupture of a Splenic Artery Aneurysm into the Pancreatic Duct)

Hemorrhage through the pancreatic duct into the duodenum is rare presentation of upper gastrointestinal bleeding. This condition is most commonly associated with inflammatory disorders of the pancrease with the bleeding originating from an area of hemorrhagic pancreatitis, abscess, or pseudocyst. A pseudoaneurysm of the splenic artery be can form as a result of erosion and autodigestion by the inflammatory process of this major blood vessel. More frequently, splenic artery aneurysms rupture into the greater or lesser peritoneal sacs, stomach, retroperitoneum, colon, or splenic vein. We experienced a patient with a prolonged history of upper gastrointestinal bleeding in which the diagnosis of hemosuccus pancreaticus secondary to a ruptured splenic artery aneurysm was diagnosed preoperatively. We report our experience with a review of the related literature.

Diagnosis and surgical treatment of splen-aneurysm / 临床外科杂志

Objective To investigate the diagnosis and surgical treatment of splen aneurysm.Methods The diagnosis and surgical treatment of 12 patients with splen-aneurysm are analysed retrospec tively between 1987 and 2000.Results The clinical findings of most cases were urgent and critical including 8 patients of severe abdominal pain,2 patients of disruption and bleeding of tumor body,4 abdominal pain and u pset,andabdominal impulsive mass,except that 1 patient had no clinical finding owing to health survey.Ultrasonic examination by color Doppler＇s method was the most essential means in diagnosis,even if a patient was suspected having disrupt ion and bleeding of tumor body,he should be given up to do ultra-B examination b edside.All patients were operated in emergency or deadline and had no allo-blood supply of spleen and no perioperative death.Conclusions Al most all patients obtained final diagnosis by depending on Ultrasonic examinatio n by color Doppler＇s method.We suggest that the ligation of splenic artery aneur ysm be selected as far as possible according to several patient＇s conditions bec ause it has simple?safe and effective speciality.

Experience of Splenic Artery Aneurysms

PURPOSE: Splenic artery aneurysm is uncommon, but the increased frequency in use of arteriography, computed tomography, and ultrasonography has resulted in increasing clinical recognition of these lesions. This paper relates our experience in the outcome and management of aneurysms of the splenic artery. METHODS: From January 1992 to October 1999, 12 patients were diagnosed with splenic artery aneurysms. They were retrospectively analyzed. RESULTS: The male to female ratio was 1:4 and the mean age was 46.3 years. The mean of pregnancy history of all women was 3.0 and there were no pregnant women during operation. The associated diseases that might have caused the aneurysms were pancreatitis in 5 patients, portal hypertension in 1, operative trauma in 1, and ill defined pathogenesis in 5 patients. The size of the aneurysms was larger than 2 cm in all patients. The splenic artery aneurysms was located at distal in 9 patients, mid in 1, and proximal in 2 patients. 7 patients were treated surgically (aneurysmectomy without splenectomy in 1 patient, aneurysmectomy with splenectomy in 6 patients). Transcatheter embolization was used in 4 patients. One of them was treated with distal pancreatectomy after two months because of pancreatic pseudocyst. One patient without treatment died 2 years after diagnosis. CONCLUSION: Although surgery remains necessary in splenic artery aneurysms larger than 2 cm, transcatheter embolization is effective in initial treatment of the high risk group in splenic artery aneurysms.