[Aneurysms of digestive arteries. What are the indications?]

Twelve cases of visceral artery aneurysms have been retrospectively reviewed in order to evaluate the results of the various therapeutic decisions. Aneurysms were located on splenic (n = 5), hepatic (n = 1), celiac (n = 3), superior mesenteric (n = 1), pancreatico-duodenal arteries (n = 1) and superior mesenteric artery branches (n = 2). Among two patients operated on for ruptured aneurysms, one patient who suffered from free intraperitoneal hemorrhage died after the operation. All patients operated on with unruptured aneurysms survived. Among two patients who were not operated on because of the small size of the aneurysms, one died suddenly a few years later from an unknown cause which may have been a rupture, and the second one was lost from the survey. Our results and those in the literature suggest that surgical treatment (or in some cases percutaneous embolization) is indicated in any symptomatic aneurysm and in most asymptomatic aneurysms except in splenic artery aneurysms. The latter should be operated on only when the diameter is more than 2.5 cm or when they are found in pregnant women or in women with child-bearing capacity.