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

ABSTRACT

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.