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The third most common site of what is known as intra-abdominal aneurysms is the splenic artery. While women are four times more likely to experience a splenic artery aneurysm, they are more likely to rupture in men. The distal part of the artery is most often affected and about two to three percent of patients experience a rupture. An aneurysm is best defined as an abnormal ballooning or widening of a part of the artery as a result of a weakness in the blood vessel wall.
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There are several causes of this condition. Causes include portal hypertension, blunt or penetrating abdominal trauma, infection, medial fibromuscular dysplasia, multiple pregnancies, and pancreatitis. Those with these causes should ensure they are always on the lookout for this condition.
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Signs and Symptoms
The signs and symptoms often vary. These aneurysms may cause a pulsating sensation, distal ischemic symptoms, stroke, local pain, transient ischemic attacks, and hoarseness. Compression of the adjacent veins may cause edema or venous thrombosis. Compression of the brachial plexus or recurrent laryngeal nerve may cause impaired sensory function or motor function. Inflammatory or mycotic aneurysms may cause the symptoms of a systemic infection, such as weight loss, fever, and malaise, and it may also cause local pain.
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The majority of splenic artery aneurysms are not diagnosed until they rupture, but occult aneurysms or calcified aneurysms may be seen when diagnostic imaging is done for another reason. To confirm or detect on of these aneurysms, CT scans or ultrasonography are typically performed. If necessary, angiography may be used to take a look at any distal symptoms that are believed to be caused by an embolism or an aneurysm.
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Treating a splenic artery aneurysm involves surgical intervention. There is approximately a ten percent chance of death due to rupture so it is very important to treat this condition. Women who are in their child-bearing years have the highest chance of death. Repairing these aneurysms may consist of aneurysm exclusion and vascular reconstruction or ligation without arterial reconstruction. A splenectomy may have to be performed depending on where the aneurysm is located. Aggressive antibiotic therapy is necessary for mycotic aneurysms and it is directed at the specific pathogen. In general, mycotic aneurysms must also be repaired surgically.
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Prognosis and Complications
In most cases, the outlook is excellent as long as the aneurysm is successfully surgically repaired.
With aneurysms in the splenic artery, massive bleeding is commonly seen. If an aneurysm ruptures, the massive bleeding associated with it may result in death. Other possible complications include:
- Infection that may lead to a rupture and body-wide illness
- The nearby structures, like the nerves, may become compressed, which can result in signs and symptoms, such as numbness and weakness
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The Merck Manuals Online Medical Library. (2008). Aneurysms. Retrieved on January 28, 2011 from The Merck Manuals Online Medical Library: http://www.merckmanuals.com/professional/sec07/ch079/ch079b.html
Health Central. (2008). Aneurysm. Retrieved on January 28, 2011 from Health Central: http://www.healthcentral.com/cholesterol/complications-1177-108.html?ic=506048