Splenic artery aneurysms

The records of 100 patients with documented splenic artery aneurysms seen between January 1960 and January 1980 were reviewed. Eighty-seven were women and 13 men. Ages ranged from 16 to 81 years (mean 58.2 years). Eighty women (92%) had been pregnant. The number of pregnancies ranged from 1 to 16 (mean 4.5); 21 women (24.1%) had been pregnant six or more times. Aneurysm diameter ranged from 0.6 to 30 cm (mean 2.1 cm). The aneurysm was calcified in 72 patients. Most aneurysms (78%) were located in the distal third of the splenic artery and were saccular. Multiple aneurysm occurred in 29 patients. Seventeen patients were symptomatic at the time of diagnosis; all presented with abdominal pain. Rupture occurred in three patients, one of whom was pregnant; two survived. Atherosclerotic occlusive disease occurred in 21 patients. Other arterial aneurysms occurred in 12 patients. Eighty-one patients had surgical treatment. Aneurysmectomy with splenectomy was the most common procedure. The elective operative mortality rate was 1.3%. The 19 patients not undergoing surgery were followed from 1.0 to 19 years (mean 7.4 years). No ruptures or other complications of the aneurysm occurred in these patients. This study supports the view that patients who are pregnant or who present with a symptomatic splenic artery aneurysm should undergo surgical resection.