Critical Care and Shock

Successful angioembolization of two missed true aneurysms and a traumatic pseudoaneurysm in the spleen: A case report

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Introduction: Splenic artery aneurysm is often discovered incidentally. It can be treated with non-surgical management such as angioembolization if appropriately followed up after detection. However, if not adequately treated, aneurysm can have very serious consequences. We report a case of successful treatment of a new traumatic splenic pseudoaneurysm in a patient who missed two true splenic aneurysms during eight years of breast cancer follow-up.

Case presentation: A 65-year-old woman visited a regional trauma center complaining of abdominal pain in both legs after a pedestrian traffic accident. The patient had a medical history of regular follow-ups at our hospital after a mastectomy for breast cancer ten years prior. The medical staff found multiple splenic aneurysms without bleeding or rupture. We recognized that previous examinations also showed two true splenic aneurysms. The medical team determined that treatment for the multiple splenic aneurysms and focal splenic injury was the priority, and angiographic embolization was performed as an emergency. Angiographic images revealed two true splenic aneurysms and one pseudoaneurysm. Embolization was thus performed on the two true splenic aneurysms by coiling, and hemostasis was achieved through embolization of the traumatic splenic pseudoaneurysm.

Conclusion: Splenic artery aneurysms are sometimes detected incidentally during examinations for other purposes; thus, medical staff should always carefully examine imaging results.