Operative ligation of multiple splenic artery aneurysms

The incidence of splenic artery aneurysms (SAAs) in the background population is less than 1%. They are found with increasing frequency in the elderly, and there is a female predominance. The majority (95%) of SAAs are asymptomatic; although, symptoms include pain and a pulsating feeling in the upper abdomen. Treatment of SAAs depends on aneurysmal size and associated symptoms. Multiple SAAs are noted in 20% of patients. A 71-year-old woman with a history of both systemic and portal hypertension, hyper-splenism, and cirrhosis post chronic active hepatitis presented with a pulsating sensation and pain in her left hypochondrium. Abdominal ultrasound and CT confirmed the presence of two splenic aneurysms, which subsequently showed signs of enlargement 6 months later. At operation both aneurysms were successfully ligated and post-operative ultrasonography confirmed absence of aneurysmal flow and viability of the spleen.