Splenic Artery Aneurysms

Splenic artery aneurysms are found in up to 10% of autopsy series and are the second most common intraabdominal aneurysm (after aortoiliac aneurysms). They are found four times more often in women than in men, likely due to the hormonal and hemodynamic stresses of pregnancy. The main concern is rupture, half of which occur in pregnant women with a mortality rate of 70%-90%. Splenic artery aneurysms in women of childbearing age or in pregnant women, therefore, are usually treated.

Older patients with incidentally detected aneurysms are a different story. Asymptomatic patients over 60 with aneurysms less than 2 cm in diameter can be managed conservatively with follow-up CT (6-12 months). Those with symptomatic aneurysms or those with aneurysms larger than 3 cm in diameter can be treated with embolization. Aneurysms between 2 cm and 3 cm are in a gray zone.

References

Kenningham R, Hershman MJ, McWilliams RG, Campbell F. Incidental splenic artery aneurysm. J R Soc Med. 2002 Sep;95(9):460-1.