Journal of

Case Reports and Images in Surgery

 
     
Case Report
 
Massive splenic artery aneurysm with aneurysmal dilatation of the portal vein and splenic infarct
Samrat Ray1, Amitabh Yadav1, Samiran Nundy1
1Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi.

Article ID: 100036Z12SR2017
doi:10.5348/Z12-2017-36-CR-1

Address correspondence to:
Samrat Ray
Department of Surgical Gastroenterology and Liver transplantation
Room no 1474, 4th floor, Sir Ganga Ram Hospital
Rajinder Nagar, New Delhi 110060
India

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How to cite this article:
Ray S, Yadav A, Nundy S. Massive splenic artery aneurysm with aneurysmal dilatation of the portal vein and splenic infarct. J Case Rep Images Surg 2017;3:1–5.


Abstract
Introduction: Aneurysms of the splenic artery are rare but potentially life-threatening problems and the risk of complications increases manifold with their increase in size. The portal vein aneurysms are even rarer with as few as only 200 cases being reported in the surgical literature. The presence of both aneurysms in the same patient has not been previously described. Such cases present a therapeutic challenge.
Case Report: A 56-year-old apparently healthy male presented with vague upper abdominal discomfort with fever, headache and a palpable spleen. Evaluation by triple phase computed tomography of the abdomen revealed a large 9×8 cm sized aneurysm in the distal third of the splenic artery with an aneurysmal dilatation of the portal vein about 48 mm at the porta hepatis, splenomegaly with a splenic infarct and multiple gallstones. Laparotomy with distal pancreatosplenectomy, excision of the aneurysm and cholecystectomy were done. Gross evaluation of the specimen revealed a 10 cm aneurysm of the distal splenic artery containing organised thrombus within an infarct at the lower pole of the spleen.
Conclusion: Presentation of a massive splenic artery aneurysm in association with a portal vein aneurysm is an exceedingly rare clinical phenomenon. Most portal vein aneurysms being asymptomatic may be left alone and followed up periodically. We describe an extremely rare association of coexistent aneurysms of the splenic artery and portal vein which was managed by distal pancreatectomy and splenectomy.

Keywords: Aneurysm, Portal vein aneurysm, Splenic artery aneurysms


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Author Contributions
Samrat Ray – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Amitabh Yadav – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Samiran Nundy – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Samrat Ray et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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