Laparoscopic Resection of a Splenic Artery Aneurism with Spleen Preservation

Abstract

Introduction. Splenic artery aneurisms (SAA) are the third most common aneurysms, with reported incidences up to 10.4%. There is a higher prevalence in women, and most are incidental findings on imaging studies. Symptomatic or SAA larger than 20 mm and aneurysms in pregnant or in women of childbearing age are indications for surgery, because of the increased risk of rupture. Treatment options include endovascular, laparoscopic, and open surgical approaches. Presentation of Case. A 50-year-old female patient with nonspecific abdominal pain performed a computed tomography scan and angiography, which revealed a 24×20×19 mm SAA. After a multidisciplinary discussion, selective laparoscopic excision of the aneurysm was performed, with spleen preservation. Perioperative course was uneventful, and the patient remained asymptomatic. Discussion. A multidisciplinary discussion is of major importance in guaranteeing the optimal treatment for any given visceral aneurysm. Not all SAA are amenable to endovascular treatment, and laparoscopic surgery has mostly replaced open procedures. Laparoscopic ligation and resection of the SAA with splenic preservation offers permanent treatment, with a low morbidity and short hospital stay. Conclusion. Selective laparoscopic aneurysm resection is a safe and effective approach, with good short- and long-term results, allowing permanent treatment of SAA while maintaining splenic function.