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Surgery
Management of multiple splenic artery aneurysms in the setting of portal hypertension and splenomegaly
  1. Varsha Sharma1,
  2. Raleene Gatmaitan2,
  3. Michael Neale3 and
  4. Jaswinder Samra4
  1. 1 Upper Gastrointestinal/Hepatobiliary and Pancreatic Surgery Unit, Liverpool Hospital, Liverpool, New South Wales, Australia
  2. 2 Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia
  3. 3 Department of Vascular Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  4. 4 Hepatobiliary and Pancreatic Surgery Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  1. Correspondence to Dr Varsha Sharma; varsha79{at}gmail.com

Abstract

Extrahepatic portal hypertension is commonly caused by portal vein thrombosis (PVT). Clinical manifestations of this may include splenomegaly, varices and ascites. Rare complications such as splenic artery aneurysms (SAAs) can present, especially in the presence of portal hypertension; however, such cases are poorly described in the literature and can therefore present a challenge in investigative work-up and management. The case of a young woman in her late 20s with chronic extrahepatic PVT from thrombophilic disease is presented in this report. She developed splenomegaly, thrombocytopaenia from hypersplenism, oesophageal varices and multiple large SAAs. She was successfully managed by splenic artery embolisation and creation of a portosystemic shunt followed by a splenectomy.

  • Portal hypertension
  • Splenectomy
  • Gastrointestinal surgery
  • Vascular surgery

https://doi.org/10.1136/bcr-2024-260823

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    Footnotes

    • Contributors RG and VS were responsible for drafting of the text, sourcing and editing of the clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. MN and JS gave final approval of this manuscript. Senior clinician and guarantor for this manuscript: JS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.