Posttraumatic Intrasplenic Pseudoaneurysm with High-Flow Arteriovenous Fistula: New Lessons to Learn

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Vascular Surgery

Background:

• Intrasplenic pseudoaneurysm is a rare but life-threatening consequence of abdominal trauma.
• Diagnosis is often confirmed using computed tomography (CT) scans.
• Management decisions depend on pseudoaneurysm size, rupture status, and patient stability.

Purpose of the Study:

• To present a case of intrasplenic pseudoaneurysm managed with splenectomy.
• To review the literature on the interventional radiologist's role in managing this condition.
• To discuss treatment strategies, including embolization and splenectomy.

Main Methods:

• Case presentation of a 33-year-old patient with intrasplenic pseudoaneurysm.
• Diagnostic imaging using CT scan.
• Literature review of English-language publications on intrasplenic pseudoaneurysm treatment.
• Discussion of interventional radiology techniques and surgical options.

Main Results:

• The patient's pseudoaneurysm was too large for selective embolization, necessitating splenectomy.
• Interventional radiologists play a key role in assessing treatment options and risks.
• Embolization is the preferred treatment for unruptured pseudoaneurysms in selected cases.
• Splenectomy is a definitive treatment for large or ruptured pseudoaneurysms.

Conclusions:

• Intrasplenic pseudoaneurysm management requires a multidisciplinary approach.
• Embolization is ideal for early, selected cases, while splenectomy is crucial for high-risk or large pseudoaneurysms.
• The interventional radiologist's expertise is vital in determining the optimal treatment pathway.