Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Introduction
Splenic Artery Aneurysm (SAA) is a visceral artery aneurysm affecting less than one percent of the general population. Most individuals affected are women in the 5th to 6th decade of life or those with pre-existing conditions including atherosclerosis, portal hypertension, and connective tissue disorders. In this case study we describe a 19-year-old with a splenic artery aneurysm without known comorbidities.
Methods
This is an observational case study. A comprehensive chart review of the patient’s medical chart was conducted. A literature review of relevant materials was then conducted in order to evaluate for prevalence of disease and corrective management.
Results
We describe the case of a 19-year-old female with a history of hypercalcemia secondary to MEN1 syndrome who presented to the emergency department with one day of moderate left upper quadrant abdominal pain. The patient denied pertinent negatives like nausea and vomiting, but endorsed a recent history of heavy weightlifting. CT abdomen/pelvis with intravenous contrast was performed and found mild pelvis free fluid with no other abnormalities. Pertinent labs include white blood cell count 15.3, calcium 11.6, lipase within normal limits, urinalysis and urine pregnancy test were both negative. The patient was discharged home with no diagnosis. Approximately two weeks later, the patient returned to the emergency room with suprapubic and right lower quadrant pain. She was tachycardic and hypotensive upon arrival. Intra-abdominal fluid was found on bedside ultrasound exam, and the patient was given two units of packed red blood cells. She returned to hemodynamic stability. CT scan of abdomen/pelvis found hemoperitoneum through the abdomen and pelvis which appeared to be originating from the left upper quadrant, consistent with a rupture of the splenic artery. The patient was then transferred to a tertiary care center and she underwent an endovascular splenic artery embolization, and the patient was discharged home.
During the literature review, the prevalence of splenic artery aneurysm in a female of childbearing age was found to be less than 0.1 percent. The majority of those with splenic artery aneurysms are asymptomatic, and those who present with rupture include only 3-10 percent of all splenic artery aneurysms. Of those, conservative management is done if the aneurysm is less than two centimeters, does not disturb hemodynamics, and is asymptomatic. Endovascular repair or splenectomy is done when the aneurysm is greater than two centimeters, the patient has experienced hemodynamic instability, is of child-bearing age, and/or is symptomatic.
Conclusion
In this case we discussed a case of a 19 year-old female who presented with a ruptured splenic artery aneurysm. This case is exceptionally rare given the patient's only risk factor is her gender. The correct treatment is highly case-dependent, and sometimes multiple treatments must be implemented. Although this patient does have a history of hypercalcemia secondary to MEN1 we could not find any correlation between the two.
Embargo Period
5-28-2025
Included in
A rare splenic artery aneurysm in a 19-year-old female
Suwanee, GA
Introduction
Splenic Artery Aneurysm (SAA) is a visceral artery aneurysm affecting less than one percent of the general population. Most individuals affected are women in the 5th to 6th decade of life or those with pre-existing conditions including atherosclerosis, portal hypertension, and connective tissue disorders. In this case study we describe a 19-year-old with a splenic artery aneurysm without known comorbidities.
Methods
This is an observational case study. A comprehensive chart review of the patient’s medical chart was conducted. A literature review of relevant materials was then conducted in order to evaluate for prevalence of disease and corrective management.
Results
We describe the case of a 19-year-old female with a history of hypercalcemia secondary to MEN1 syndrome who presented to the emergency department with one day of moderate left upper quadrant abdominal pain. The patient denied pertinent negatives like nausea and vomiting, but endorsed a recent history of heavy weightlifting. CT abdomen/pelvis with intravenous contrast was performed and found mild pelvis free fluid with no other abnormalities. Pertinent labs include white blood cell count 15.3, calcium 11.6, lipase within normal limits, urinalysis and urine pregnancy test were both negative. The patient was discharged home with no diagnosis. Approximately two weeks later, the patient returned to the emergency room with suprapubic and right lower quadrant pain. She was tachycardic and hypotensive upon arrival. Intra-abdominal fluid was found on bedside ultrasound exam, and the patient was given two units of packed red blood cells. She returned to hemodynamic stability. CT scan of abdomen/pelvis found hemoperitoneum through the abdomen and pelvis which appeared to be originating from the left upper quadrant, consistent with a rupture of the splenic artery. The patient was then transferred to a tertiary care center and she underwent an endovascular splenic artery embolization, and the patient was discharged home.
During the literature review, the prevalence of splenic artery aneurysm in a female of childbearing age was found to be less than 0.1 percent. The majority of those with splenic artery aneurysms are asymptomatic, and those who present with rupture include only 3-10 percent of all splenic artery aneurysms. Of those, conservative management is done if the aneurysm is less than two centimeters, does not disturb hemodynamics, and is asymptomatic. Endovascular repair or splenectomy is done when the aneurysm is greater than two centimeters, the patient has experienced hemodynamic instability, is of child-bearing age, and/or is symptomatic.
Conclusion
In this case we discussed a case of a 19 year-old female who presented with a ruptured splenic artery aneurysm. This case is exceptionally rare given the patient's only risk factor is her gender. The correct treatment is highly case-dependent, and sometimes multiple treatments must be implemented. Although this patient does have a history of hypercalcemia secondary to MEN1 we could not find any correlation between the two.