Splenic Artery Aneurysm

Robert Osnis, M.D., Daniel Link, M.D., & Moni Stein, M.D.
UC Davis Medical Center

Fig. 1. A plain film shows a heavily calcified splenic artery aneurysm.

Fig. 2. Splenic arteriography shows a fusiform calcified splenic artery aneurysm.

Case Reference No. CC-0800-04

A 74-year-old woman had a lumbar spine plain film to investigate chronic lower back pain. She was noted to have an oval calcified density in the left upper quadrant (see figure 1) suggestive of a splenic artery aneurysm. A CT examination of the abdomen (not shown) confirmed this diagnosis and measured the aneurysm at 2.5 cm in its largest diameter. The patient was referred to Interventional Radiology for possible embolization. The angiogram showed a fusiform splenic artery aneurysm in its mid portion with a calcified rim. It was determined that this aneurysm as not amenable to straightforward embolization and further management options are currently being considered.

Questions:

1) What is the etiology of this entity?

2. What is the natural history of this entity?

3. Is this lesion amenable to percutaneous therapy?

4. Should this patient have a splenectomy with exclusion of the aneurysm?