Spontaneous rupture of a splenic artery aneurysm with hemoperitoneum; case presentation.

Aneurysms of the splenic artery are relatively rare, being found in patients with portal hypertension, multiparous, atherosclerosis, or in young people with various genetic diseases. In the uncomplicated forms, splenic artery aneurysms are often difficult to diagnose either because of the asymptomatic evolution, or because of the non-specific symptoms. In cases of trauma or large sizes, aneurysms can be complicated by rupture, which can cause hemoperitoneum with the risk of death if specific treatment is not initiated as soon as possible. Depending on the location of the splenic aneurysm, comorbidities, the patient's general condition or life-threatening complications, laparotomy, laparoscopy, endovascular techniques or combined procedures can be performed. The case of a 33-year-old female patient who presented to the emergency room with abdominal pain, nausea, vomiting and later syncope is presented. The patient was referred to the radiology department, and computed tomography revealed a ruptured splenic artery aneurysm with hemoperitoneum. The splenic artery aneurysm and the spleen were excised by emergency surgery, with a favorable postoperative outcome. The young age of diagnosis and treatment probably implies a genetic component, so that she was referred for additional investigations after discharge. Category: Case Presentation Received: July 26, 2024 Accepted: September 17, 2024 Published: October 30, 2024 Keywords: ruptured, splenic artery aneurysm, hemoperitoneum, trauma *Corresponding author: Ion Motofei, Carol Davila University of Medicine and Pharmacy, St. Pantelimon Emergency Clinical Hospital, Department of General Surgery, Bucharest, Romania E-mail: igmotofei@yahoo.com Introduction The splenic artery is the third most common in terms of the presence of an aneurysm on an intra-abdominal visceral vessel. Rupture of such an aneurysm can lead to retroperitoneal hematoma, massive hemorrhage with hemorrhagic shock in the case of hemoperitoneum, but also to possible fistulas with the pancreas due to the adjacent anatomical relationship [1,2]. If the dimensions do not exceed 2 cm, most aneurysms are asymptomatic and are diagnosed incidentally, by performing a computed tomography for another pathology. Such aneurysms are associated with various conditions such as pregnancy, liver cirrhosis, atherosclerosis, or in young people in case of malformations and/or genetic predispositions [3,4]. The risk of rupture and possible complications occurs with aneurysms over 5 cm in diameter, when it is necessary to implement minimally invasive measures to reduce the risk of such events. In case of rupture of the aneurysm (large sizes, trauma, etc.), it is necessary to stop the bleeding by embolization, the application of different coagulant agents or [ABSTRACT FROM AUTHOR]