Spontaneous non-traumatic splenic artery aneurysm rupture: a case report and review of the literature.

The current case report is about spontaneous non-traumatic rupture of a splenic artery aneurysm (SAA) in a 53-year-old woman with no particular medical history. An emergent laparotomy with splenectomy was required, unfortunately without success as the patient died. SAA is the most common visceral artery aneurysm. Most of SAA remain asymptomatic and are discovered incidentally on imaging. The overall risk of rupture increases with the size of SAA, especially when above 2 cm. Initial presentation of SAA has been associated with acute rupture and hemodynamic instability leading to substantial perioperative morbidity and mortality.

Phenotypic identification and development of distinct microvascular compartments in the postnatal mouse spleen.

In this paper we report the development of the sinus network of mouse spleen during the first postnatal month as studied with a set of new rat monoclonal antibodies (mAbs) against mouse splenic endothelial cell subpopulations. One of the new mAbs (IBL-7/1) also stained B-cell lineage cells in the spleen shortly after the birth as confirmed by three-color flow cytometry. This B-cell staining in the primordial follicles vanished by the fourth postnatal week, so that the expression of IBL-7/1 antigen was restricted to the marginal sinus endothelium and some red pulp sinuses and a minor B-cell subset in the spleen, presumably distinct from the follicular B-cell compartment. The other mAb (IBL-9/2) selectively labeled the sinusoids of the deeper part of the red pulp, without any reactivity against hemopoietic cells. The IBL-9/2-reactive cells in newborns appeared as isolated elements throughout spleen, and during the segregation of white and red pulps they formed an extensive network in the red pulp outside the marginal zone. Double-labeling immunofluorescence revealed that most of these sinusoids also stained weakly with IBL-7/1 mAb, whereas the strongly IBL-7/1-positive vessels of this region were IBL-9/2 negative. Neither of these mAbs reacted with the central artery. The comparative phenotypic analysis of the various vascular segments indicates that the splenic sinusoids of the marginal zone and red pulp, respectively, are lined with a heterogeneous array of endothelium. For the precise identification, isolation, and characterization of the possible homing function of these endothelium subsets these region-specific mAbs may be of potential value.

Morphometry of the human splenic artery: muscular columns, morphofunctional aspects and developmental implications.

There is a paucity of studies in the literature concerning the structural characteristics of the arterial wall in the abdominal region using human material and specialized morphometric techniques. In the present study we carry out the morphometric study, describing a series of structural peculiarities in 12 segments of the human splenic artery. Among these the presence of length-wise or spiral-shaped muscular columns in the medial layer which mark and reduce the diameter of the arterial lumen is of major importance. In its underlying intima small localized thickenings appear which, with age may become generalized. We also analyze the different intimal thickenings and such indices as the Intimal Thickening Index, Lumen Reduction Index and Pathologic Thickening Index, with differences among the groups we have considered. The study of elastin in the various parietal structures help us to understand the possible pathogenesis of the thickenings, and to clarify the important morphological-functional correlation for the regulation of blood flow which exists in this arterial region.

Indicial functions of arterial remodeling in response to locally altered blood pressure.

We investigated the effect of locally altered blood pressure on the remodeling processes of the cells and extracellular matrices of the splenic and ileal arteries and used an indicial function approach to quantitatively analyze the relationship between the altered blood pressure and the remodeling processes. Blood pressure in these arteries was locally modulated by constricting the aorta at a location between the celiac and mesenteric bifurcations, resulting in a higher blood pressure at the splenic arteries then at the ileal arteries, After the pressure changes, the cross-sectional areas and the fractions of the cells and extracellular matrices of the splenic and ileal arteries were examined by electron microscopy at 2, 6, 10, 20, and 30 days. We found that both arteries remodeled, but the splenic arteries (higher blood pressure) remodeled more rapidly and to a larger degree than the ileal arteries (lower pressure compared with the splenic arteries) of the same animal. To verify whether an identical change in the blood pressure at the splenic and ileal arteries leads to the same remodeling process in these arteries, we created another model by constricting the aorta at a location between the mesenteric and renal bifurcations, resulting in hypertension of the same level at both splenic and ileal arteries. We found that the remodeling processes of the cells and matrices were almost identical in the arteries with similar changes in blood pressure. Thus we conclude that the remodeling processes of cells and matrices of the splenic and ileal arteries are dependent on the local blood pressure in aorta constriction-induced hypertension, and the indicial analysis is a useful approach in the description of the relationship between the blood pressure and the arterial remodeling processes.