Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis

Introduction. Splenic artery aneurysm (SAA) represents the third cause of abdominal aneurysms, just after abdominal aorta and iliac arteries aneurysms, with overall prevalence of 1%. Pancreatitis has been linked with pseudoaneurysm formation of SA due to destruction of arterial wall by pancreatic en...

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Autores principales:	Tanasković Slobodan, Gajin Predrag, Ilić Miodrag, Matić Predrag, Kovačević Vladimir, Atanasijević Igor, Ilijevski Nenad
Formato:	article
Lenguaje:	EN SR
Publicado:	Serbian Medical Society 2021
Materias:	splenic artery aneurysm chronic pancreatitis primary biliary cholangitis spleen-preservation surgery Medicine R
Acceso en línea:	https://doaj.org/article/2c674aa02fc84272b5e4ad43b7b0a1ee
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spelling	oai:doaj.org-article:2c674aa02fc84272b5e4ad43b7b0a1ee2021-11-10T07:28:09ZSpleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis0370-81792406-089510.2298/SARH210121060Thttps://doaj.org/article/2c674aa02fc84272b5e4ad43b7b0a1ee2021-01-01T00:00:00Zhttp://www.doiserbia.nb.rs/img/doi/0370-8179/2021/0370-81792100060T.pdfhttps://doaj.org/toc/0370-8179https://doaj.org/toc/2406-0895Introduction. Splenic artery aneurysm (SAA) represents the third cause of abdominal aneurysms, just after abdominal aorta and iliac arteries aneurysms, with overall prevalence of 1%. Pancreatitis has been linked with pseudoaneurysm formation of SA due to destruction of arterial wall by pancreatic enzymes, however true SAA associated with pancreatitis has not been described yet. We are presenting the first case of true SAA in a patient with chronic pancreatitis and primary biliary cholangitis successfully treated by surgical excision, direct arterial reconstruction and spleen preservation. Case outline. A 74-year-old male patient was admitted for multidetector computed tomography angiography due to suspected SAA and renal artery aneurysm (RAA). He was previously treated for chronic pancreatitis and primary biliary cholangitis. Upon admission, computed tomography arteriography showed SAA 32 mm in diameter and RAA 12 mm with SAA being in direct contact with superior margin of the pancreas. Surgical treatment of SAA was indicated while RAA was treated conservatively. Intraoperatively, SAA adherent to the superior margin of pancreas was noted, followed by complete exclusion of the aneurysm and end-to-end splenic artery anastomosis. Histopathology showed atherosclerotic degeneration of arterial wall with all three layers presenting as true aneurysm. Two years after the surgery, control computed tomography angiography showed regular postoperative findings without further progression of RAA. Conclusion. This is the first case to describe a true SAA aneurysm originated on the field of previous episodes of chronic pancreatitis and primary biliary cholangitis. Surgical treatment including aneurysm resection and direct arterial reconstruction with spleen preservation showed satisfactory results.Tanasković SlobodanGajin PredragIlić MiodragMatić PredragKovačević VladimirAtanasijević IgorIlijevski NenadSerbian Medical Societyarticlesplenic artery aneurysmchronic pancreatitisprimary biliary cholangitisspleen-preservation surgeryMedicineRENSRSrpski Arhiv za Celokupno Lekarstvo, Vol 149, Iss 9-10, Pp 622-625 (2021)
institution	DOAJ
collection	DOAJ
language	EN SR
topic	splenic artery aneurysm chronic pancreatitis primary biliary cholangitis spleen-preservation surgery Medicine R
spellingShingle	splenic artery aneurysm chronic pancreatitis primary biliary cholangitis spleen-preservation surgery Medicine R Tanasković Slobodan Gajin Predrag Ilić Miodrag Matić Predrag Kovačević Vladimir Atanasijević Igor Ilijevski Nenad Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
description	Introduction. Splenic artery aneurysm (SAA) represents the third cause of abdominal aneurysms, just after abdominal aorta and iliac arteries aneurysms, with overall prevalence of 1%. Pancreatitis has been linked with pseudoaneurysm formation of SA due to destruction of arterial wall by pancreatic enzymes, however true SAA associated with pancreatitis has not been described yet. We are presenting the first case of true SAA in a patient with chronic pancreatitis and primary biliary cholangitis successfully treated by surgical excision, direct arterial reconstruction and spleen preservation. Case outline. A 74-year-old male patient was admitted for multidetector computed tomography angiography due to suspected SAA and renal artery aneurysm (RAA). He was previously treated for chronic pancreatitis and primary biliary cholangitis. Upon admission, computed tomography arteriography showed SAA 32 mm in diameter and RAA 12 mm with SAA being in direct contact with superior margin of the pancreas. Surgical treatment of SAA was indicated while RAA was treated conservatively. Intraoperatively, SAA adherent to the superior margin of pancreas was noted, followed by complete exclusion of the aneurysm and end-to-end splenic artery anastomosis. Histopathology showed atherosclerotic degeneration of arterial wall with all three layers presenting as true aneurysm. Two years after the surgery, control computed tomography angiography showed regular postoperative findings without further progression of RAA. Conclusion. This is the first case to describe a true SAA aneurysm originated on the field of previous episodes of chronic pancreatitis and primary biliary cholangitis. Surgical treatment including aneurysm resection and direct arterial reconstruction with spleen preservation showed satisfactory results.
format	article
author	Tanasković Slobodan Gajin Predrag Ilić Miodrag Matić Predrag Kovačević Vladimir Atanasijević Igor Ilijevski Nenad
author_facet	Tanasković Slobodan Gajin Predrag Ilić Miodrag Matić Predrag Kovačević Vladimir Atanasijević Igor Ilijevski Nenad
author_sort	Tanasković Slobodan
title	Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
title_short	Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
title_full	Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
title_fullStr	Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
title_full_unstemmed	Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
title_sort	spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis
publisher	Serbian Medical Society
publishDate	2021
url	https://doaj.org/article/2c674aa02fc84272b5e4ad43b7b0a1ee
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Spleen-preserving surgical treatment of splenic artery aneurysm secondary to chronic pancreatitis and primary biliary cholangitis

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