Ver el código de «Splenic artery aneurysm»

==Background==
*The most common visceral arterial aneurysm, and the third most common abdominal aneurysm (after aorta and iliac vessels)
*Etiologies include arterial fibrodysplasia, portal hypertension, and increased splenic AV shunting in pregnancy
*Incidence on CT = 0.8%<ref name="khosa">Khosa, Faisal, MD. "Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings." Journal of the American College of Radiology 10.10 (2013): 789-94.</ref>
*Female:Male 4:1
*2% result in life-threatening rupture
*Increase risk of rupture in pregnancy (most commonly in 3rd trimester).  <ref>Parrish J, Maxwell C, Beecroft J. Splenic Artery Aneurysm in Pregnancy. JOGC. 2015; 37(9):816–818.</ref>
**Thought to be secondary to increase in estrogen, progesterone and relaxin causing aneurysmal dilatation. 
**High maternal and fetal mortality post-rupture

==Clinical Features==
*Typically asymptomatic or vague with [[left upper quadrant pain]] with radiation to the left shoulder or subscapular area (most are incidental CT finding)
*May have epigastric/abdominal pain and/or hemodynamic instability if ruptured

==Differential Diagnosis==
*Calcified left adrenal haematoma
*Other causes of hemoperitoneum if ruptured
**Ruptured [[ectopic pregnancy]]

==Evaluation==
*CTA Abdomen/Pelvis is the gold standard<ref>Casadei R. et al. Thrombosed splenic artery aneurysm simulating a pancreatic body mass: can two entities be distinguished preoperatively thus avoiding diagnostic and therapeutic mistakes? JOP 2007;8:235–9</ref>
*Initial [[FAST exam]] may show fluid in left upper quadrant if ruptured aneurysm

==Management==
*Surgery and/or IR consult
*Ruptured aneurysm requires emergent laparotomy or endovascular intervention

==Disposition==
*Discharge:
**Aneurysm size <2cm, asymptomatic, and hemodynamically stable
**Follow-up with PCP and/or vascular surgery for surveillance scans at 6 months and then every 1-2 years.
*Admit:
*Aneurysm of any size in symptomatic patients, cirrhotic patients undergoing liver transplant, patients with α-1 antitrypsin deficiency, and patients who are pregnant or of childbearing age (requires consultation with a vascular surgeon for ligation or embolization)
*Aneurysm size >2cm (Requires consult with a vascular surgeon for ligation or embolization)<ref>Lakin, Ryan O., MD. "The Contemporary Management of Splenic Artery Aneurysms." Journal of Vascular Surgery 53.4 (2011): 1157.</ref>

==See Also==
*[[Abdominal aortic aneurysm]]

==External Links==

==References==
<references/>

[[Category:Vascular]]
[[Category:GI]]
[[Category:Surgery]]