A CASE OF RUPTURED IDIOPATHIC ANEURYSM OF THE SPLENIC ARTERY

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  • 特発性脾動脈瘤破裂の1例

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Abstract

We experienced a patient with ruptured idiopathic aneurysm of the splenic artery presenting typical delayed rupture phenomenon who was definitely diagnosed by CT and successfully operated on.<br> A 47-year-old man was transferred to the hospital because of an upper abdominal pain followed by shock. CT visualized an aneurysm of the splenic artery and an emergency laparotomy was performed. Splenectomy including the aneurysm at the splenic hilus was carried out. Histologically only an interruption of the tunica media was noted, and there was no previous history of having any underlying disease or trauma. So the aneurysm was diagnosed as idiopathic.<br> The splenic artery is the most common site for rupture of the aneurysm among all arteries except the aorta and renal artery. The mortality rate comes to 39%. It presents with upper abdominal pain and shock, and temporary hemostasis can occur due to tamponade in the omental bursa (delayed rupture phenomenon). Most cases can be definitely diagnosed by angiography, but some aneurysms are visualized by CT like this case. The aneurysm of the splenic artery predominantly appears in the branches of the splenic artery and consequent splenectomy is often employed. For successfully saving the lives of such patients, appropriate management of the disease in an acute stage and timely diagnosis and treatment are important.

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