Distal çölyak arterden origin alan splenik arter diseksiyonu ile kısmen tromboze proksimal splenik arter disekan anevrizması

Yıl 2014, Cilt: 27 Sayı: 2, 138 - 140, 20.05.2014

Süha Akpınar Banu Alıcıoğlu

Öz

Splenik arter diseksiyonu oldukça ender rastlanan ve yaşayan
hastalarda tanısı zor konan bir antitedir. Splenik arter anevrizması
(SAA) ise en sık saptanan abdominal viseral anerizma olup
asemptomatik seyretmekte ve genellikle splenik arterin orta veya
distal segmentinde saptanmaktadır. Splenik arter diseksiyonları,
büyük çoğunlukla postmortem çalışmalarda tanı konmakta
öncesinde açıklanamamış üst abdomen semptomları ile
seyretmektedir. Bu yazıda, hastamızın çöliak arter distalinden
splenik arter 1/3 proksimaline uzanan diseksiyon flebi ile kısmen
tromboze olmuş disekan anevrizmayı gösteren çok kesitli
bilgisayarlı tomografi (ÇKBT) görüntüleri ile birlikte bu antite
tartışılmıştır. 

Anahtar Kelimeler

Splenik arter diseksiyonu, Splenik arter anevrizması, Disekan anevrizma

A partially thrombosed dissecting aneurism of the splenic artery extending from the coeliac origin of the artery

Öz

Splenic artery dissection is an extremely rare entity rarely
diagnosed in living individuals. However, splenic artery aneurysms
(SAA) are the most frequent vascular aneurysms of the abdominal
viscera and they are asymptomatic, usually located in the middle or
distal segment of the splenic artery. Splenic artery dissections are
almost always diagnosed at postmortem usually in patients with
previous unexplained upper abdominal symptoms. We report
multidetector computed tomography (MDCT) scans of a splenic
artery aneurysm with a dissecting flap extending from the distal
end of the coeliac artery to the proximal one third of the splenic
artery with a partially thrombosed false lumen. When we searched
the English language literature this is one of the few cases reported
as having been diagnosed in a living patient.

Anahtar Kelimeler

Splenic artery dissection, Splenic artery aneurysm, Dissecting aneurysm

Kaynakça

• 1. Takayama T, Miyata T, Shirakawa M, Nagawa H. Isolated spontaneous dissection of the splanchnic arteries. J Vasc Surg 2008; 48: 329-33.
• 2. D’Ambrosio N, Friedman B, Siegel D, Katz D, Newetia A, Hines J. Spontaneous isolated dissection of the celiac artery: CT findings in adults. AJR 2007; 188: W506-11. doi: 10.2214/AJR.06.03153
• 3. Merrel SW, Gloviczki P. Splenic artery dissection: a case report and review of the literature. J Vasc Surg 1992; 15: 221-5. doi: 10.1016/0741-5214(92)70032-G4
• 4. Abbas MA, Stone WM, Fowl RJ, et al. Splenic artery aneurysms: two decades experience at Mayo Clinic. Ann Vasc Surg 2002; 16: 442–9. doi: 10.1007/s10016-001-0207-45
• 5. Pulli R, Dorigo W, Troisi N, Pratesi G, Innocenti AA, Pratesi C. Surgical treatment of visceral artery aneurysms: A 25-year experience. J Vasc Surg 2008; 48: 334-2. doi: 10.1016/j.jvs.2008.03.0436
• 6. Choi JY, Kwon OJ. Approaches to the management of spontaneous isolated visceral artery dissection. Ann Vasc Surg 2013; 27: 750–7. doi: 10.1016/j.avsg.2012.09.0167
• 7. Hung RK, Loh C, Goldstein L. Selective us of electrolytic detachable and fibered coils to embolize a wide-neck giant splenic artery pseudoaneurysm. J Vasc Surg 2005; 41: 889-92. doi: 10.1016/j. jvs.2005.02.0268
• 8. Pescarus R, Montreuil B, Bendavid Y. Giant splenic artery aneurysms: case report and review of the literature. J Vas Surg 2005; 42: 344–7. doi: 10.1016/j.jvs.2005.04.0269
• 9. Schaeffer E, Landy C, Masson Y, Nadaud J, Plancade D. Spontaneous celiac trunk dissection complicated by multiple visceral ischaemia: A case report. Ann Fr Anesth Reanim 2013; 32: e77–8. doi: 10.1016/j. annfar.2013.02.00410
• 10. Zhang WW, Killeen JD, Chiriano J, Bianchi C, Teruya TH, AbouZamzam AM. Management of symptomatic spontaneous isolated visceral artery dissection: is emergent intervention mandatory? Ann Vasc Surg 2009;23:90e4. doi: 10.1016/j.avsg.2008.07.00311
• 11. Obon-Dent M, Shabaneh B, Dougherty KG, Strickman NE. Spontaneous celiac artery dissection: Case report and literature review Tex Heart Inst J 2012;39:703-6.