Spontaneous Rupture of Splenic Artery Aneurysm: A Case Report

Abstract

Introduction: Splenic artery aneurysm is a rare condition but the true incidence is unknown as the majority of the cases are asymptomatic. The major complication of Splenic artery aneurysm is spontaneous rupture and carries a mortality rate of 25%. Young women, usually during the third trimester of pregnancy, are at an increased risk of Splenic artery aneurysm rupture, with pregnancy accounting for 20% to 50% of all ruptures. Presentation of Case: A 25-year-old female patient presented to the emergency department with a story of a nonspecific abdominal pain in the left flank. The case evolves with syncope and hemorrhagic shock. The radiology findings documented a massive hemoperitoneum caused by the rupture of a splenic artery branch aneurysm at the hilum. The patient was submitted to emergency laparotomy and splenectomy. Immediate post-operative care and followings days were uneventful. Discussion: The majority of splenic artery aneurysms are incidentally discovered on CT scans and, when symptoms do occur, they are typically nonspecific. Current guidelines suggest that asymptomatic true splenic artery aneurysms less than 3 cm in diameter and showing little or no growth can be safely managed through observation. When rupture of splenic artery aneurysms occur this demands an intensive and immediate resuscitation and surgical intervention for patient survival. Conclusion: Although splenic artery aneurysm rupture is a rare cause of hypovolemic shock in the emergency department, it should be considered in patients presenting with abdominal pain and hypovolemia. High degree of suspicion and prompt diagnosis is crucial for life saving intervention.