Huge splenic artery aneurysm after portocaval shunt

A 64-year-old man with cirrhosis of the liver had a palpable, pulsatile palm-size mass over the upper abdomen. Splenic artery aneurysm was diagnosed by sonography, computed tomography scan, and celiac angiography. Operative findings showed a huge splenic artery aneurysm (20 X 30 X 20 cm) over the middle portion of the splenic artery. Such a huge splenic artery aneurysm may develop because changes in splenic circulatory dynamics after a portocaval shunt, resulting in compression of the splenic vein and congestive splenomegaly.