Splenic Artery Aneurysm associated with Chronic Pancreatitis due to Tuberculous Infection

ABSTRACT

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.