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Ruptured visceral artery aneurysms

W H Wagner1, A D Allins, R L Treiman

  • 1Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Annals of Vascular Surgery
|July 1, 1997
PubMed
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Ruptured visceral artery aneurysms are rare but serious, often presenting with severe symptoms. Simple ligation is frequently an effective treatment, preventing misdiagnosis and inappropriate surgeries.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Abdominal Imaging

Background:

  • Visceral artery aneurysms (VAAs) are uncommon vascular lesions.
  • Rupture of VAAs is rare and typically presents with significant symptoms.

Observation:

  • A study reviewed nine patients with ruptured VAAs between 1972 and 1992.
  • Commonly affected arteries included splenic, hepatic, celiac, and superior mesenteric arteries.
  • Symptoms ranged from hemodynamic instability to gastrointestinal bleeding due to erosion into adjacent organs.

Findings:

  • Six patients presented with abdominal pain, distension, and hemodynamic instability.
  • Three patients experienced recurrent gastrointestinal bleeding, leading to unnecessary surgeries.
  • Treatment options included ligation, resection, or bypass, with simple ligation being effective in most cases.

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  • One death occurred due to a superior mesenteric artery aneurysm.

    • Implications:

    • Early recognition of VAAs, especially those eroding into viscera, is crucial.
    • Accurate diagnosis can prevent diagnostic delays and inappropriate gastrointestinal interventions.
    • Prompt management, often with ligation, can lead to favorable outcomes without end-organ dysfunction.