A subepithelial mass determined by EUS to be a splenic artery aneurysm - 22/08/11
Doi : 10.1016/j.gie.2006.06.015
| Commentary Splenic artery aneurysm (SAA), first described in 1770 by Beaussier, precipitated a change in American history after President Garfield died (1881) from a ruptured SAA 2 months after being shot by Leon Guiteau; the bullet could not be found (until autopsy) despite the efforts of Alexander Graham Bell and his newly devised “induction balance” (metal detector). SAA is the most common aneurysm of the splanchnic vessels, and the splenic artery is the third most common vessel to be so affected after the abdominal aorta and internal iliac artery. Predisposing factors for SAA include female sex, pregnancy, and portal hypertension. SAAs have slow growth rates, and most ruptures occur with pregnancy. Although diagnostically helpful, as in this case, calcification does not completely protect against rupture. EUS and Doppler US were invaluable in defining the nature of the lesion. Treatment is recommended if the SAA is enlarging, is ≥2 cm in diameter, causes symptoms, or occurs in women considering pregnancy. Treatment is individualized and includes ligation and embolization, with or without splenectomy. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2007
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 65 - N° 1
P. 153-154 - janvier 2007 Retour au numéro
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