PMC7533310_01
Computed tomography and angiography images.. (a) Enhanced abdominal computed tomography showed a splenic artery aneurysm of 37 mm in diameter, which was located near the splenic hilum (arrowhead). Fluid collection was present around the splenic artery aneurysm, particularly in the lesser sac (arrow). (b) Selective angiography of the splenic artery showed the splenic artery aneurysm without apparent active extravasation (arrow). Multiple peripheral arteries were situated distal to the splenic artery aneurysm and might have been connected to the aneurysm.
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This revealed an SAA of 37 mm in diameter located near the splenic hilum, associated with massive adjacent fluid collection (Fig. 1a). While subsequent selective angiography of the splenic artery showed an SAA with no evidence of ongoing extravasation, interventional isolation was considered an ineffective approach because multiple peripheral branches of the splenic artery were involved (Fig. 1b).
Macroscopic and microscopic findings.. (a) Splenectomy was performed with excision of the splenic artery aneurysm (arrow) and pancreatic tail (arrowhead). (b) The wall of the splenic artery aneurysm showed complete rupture of all three vascular layers (arrow). Hematoxylin and eosin stain; original magnification, x10.
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Because pancreatic injury occurred at the time of clamping, pancreatectomy at the small part of the tail was performed with staple closure (Fig. 2a). Pathological examination revealed disruption of all vascular layers, confirming SAA rupture (Fig. 2b).