Splenic artery aneurysms

Nine aneurysms of the splenic artery are reported. The most remarkable etiopathogenic factors are female predominance, pregnancy, portal hypertension, and arteriosclerosis. Histologic findings are significant in woman: subendothelial thickening, internal elastic lamina fragmentation, medial fibrodysplasia, and accumulation of acid glycosaminoglycans in both subintimal and medial layers. In addition to these changes, two women suffering rupture during pregnancy presented microcystic degeneration. Six patients were operated and in 5 instances aneurysmectomy with splenectomy was performed; in the remaining patients the spleen was preserved. All six patients survived the operation and the postoperative period was free of problems in 5 instances. A woman suffering from gestational rupture required reoperation because the preserved spleen was bleeding and the fetus dead. The utility of arteriography in all patients with portal hypertension and the need to include this problem in the diagnostic methodology of shock occurring during pregnancy are emphasized.