ABERRANT SPLENIC ARTERY ANEURYSM

Introduction. Aberrant splenic artery aneurysms are extremely rare; indeed, only nine cases have been reported to date and in all them the same diagnostic and therapeutic criteria are assumed as in the case of orthotopic splenic artery aneurysms. Case report. A 30-year-old female, in the 20th week of pregnancy, in whom a splenic aneurysm was discovered during the course of an abdominal ultrasonography scan carried out because of a renal colic. Magnetic resonance angiography and arteriography confirmed the existence of a splenic artery aneurysm with an abnormal origin in the root of the superior mesenteric artery. In view of the retropancreatic position of the aneurysm, together with the patient's advanced gestational status, endovascular treatment was chosen. Attempts were made to embolise the aneurysm on a non-covered stent support; after confirming that this was not possible, a covered stent was placed on the superior mesenteric artery, the aneurysm was excluded and arteriography was used to confirm its immediate thrombosis. Conclusions. Due to the potential risk of rupture and the very high mortality rate associated with such an event, splenic artery aneurysms must be treated in the pregnant female. The technique that is to be employed remains a matter of controversy, especially in pregnant females, and depends on the experience of the surgical team, as well as on the particular characteristics of each patient and each aneurysm.