Have you ever heard of a splenic artery aneurysm? The name may sound a little scary, but don't worry. Let's talk about it in a simple way that you can understand. Most of the time, this condition can be present without any symptoms, but sometimes it can present with things like pain in the upper left side of the abdomen.
What is this splenic artery aneurysm?
Simply put, your spleen has a main blood vessel, an artery , that supplies blood, and when part of the wall of that artery weakens and bulges out like a balloon, we call it an aneurysm . Think of it like a water pipe that bulges out in one place when it gets old. Over time, this bulge can get bigger. The bigger the bulge, the more damage it can cause. To be precise, if the splenic artery bulges by 1.0 cm or more, we call it a splenic artery aneurysm. Sometimes it can be asymptomatic for a long time. But sometimes it can also show symptoms that require emergency medical treatment. Therefore, it is very important to be aware of this, that is, the symptoms and risk factors.
How common is this condition? Who is more likely to get it?
This condition, called a splenic artery aneurysm, affects between one in 1,000 and one in 2,500 people. That means, while it may not seem like a big deal, it is the most common type of aneurysm that develops in the arteries inside our stomach (visceral artery aneurysm).
This can affect adults of all ages. But if you're a woman , especially over the age of 60 , you're at a slightly higher risk. In fact, it's also notable that about 80% of these aneurysms occur in women .
How does an aneurysm affect the body? Is it dangerous?
Normally, our arteries are very flexible. They contract and expand as blood flows through them, but they don't lose their normal shape. But when an aneurysm forms, a weak spot in the artery causes it to bulge outward. It's like a rubber band being pulled in one spot. The wall of the artery is very weak at that point. Over time, if left untreated, this can lead to serious complications .
Splenic Artery Aneurysm is a serious medical condition . It can sometimes be life-threatening, especially if you are pregnant . Like other aneurysms, this one is dangerous because it can rupture or dissect . These ruptures and dissections are life-threatening emergencies that require immediate medical attention.
There is another thing, it is called pseudoaneurysms , which means 'false aneurysms'. These can also affect the splenic artery. In a true aneurysm, all layers of the artery wall are affected. In a pseudoaneurysm, only one or two layers are affected. However, this pseudoaneurysm of the splenic artery is also very serious, and is more likely to burst than a true aneurysm.
What are the symptoms of a splenic artery aneurysm?
There are several symptoms you may experience if you have this aneurysm.
- Pain in the upper left side of your abdomen . This pain may also radiate to your left shoulder.
- A pulsating feeling in the upper left part of the abdomen.
Imagine what would happen if this aneurysm burst . Then you might suddenly experience symptoms like:
- Nausea and vomiting .
- A sharp pain in the upper abdomen , just below your ribs.
- Pain in the left shoulder .
- Symptoms of hypovolemic shock (a condition caused by a decrease in the amount of blood in the body).
This outbreak can occur suddenly, or it can occur in two stages. About one in four people experience a combination of these two stages. That is, symptoms appear suddenly, then subside temporarily. But that relief is short-lived, and the body quickly goes into shock.
The most important thing is that if you have any of the symptoms of a splenic artery aneurysm or rupture, you should immediately call 1990 or your local emergency number.
Many people don't have any symptoms until an aneurysm is about to rupture or has ruptured. That's why it's so important to know your risk factors and talk to your doctor about your risk level.
Why does this splenic artery aneurysm form?
A weakness in the wall of the splenic artery is the primary cause of this aneurysm. It's not always clear exactly what causes this weakness. However, researchers have found that there are many risk factors that can contribute to the condition.
Of these , pregnancy is a very important risk factor. Also, this risk is even higher for women who have been pregnant before. During pregnancy, hormonal changes affect your blood flow, increasing the pressure inside the splenic artery. This can weaken the artery walls and cause an aneurysm to form.
Various other medical conditions can also increase the risk of developing a splenic artery aneurysm. Here are a few examples:
- High blood pressure (Arterial hypertension)
- Atherosclerosis
- Brain aneurysm
- Cirrhosis of the liver
- Connective tissue diseases, for example Marfan syndrome
- Diabetes (Diabetes Mellitus)
- Infection of the inner lining of the heart (Endocarditis)
- Fibromuscular dysplasia (FMD)
- Granulomatosis with polyangiitis (GPA) (formerly known as Wegener's)
- Liver transplantation
- Polyarteritis nodosa (PAN)
- Portal hypertension (high pressure in the veins leading to the liver)
- Vasculitis
There are also risk factors that contribute to the development of the previously mentioned pseudoaneurysms :
- Chronic pancreatitis
- Complications after surgery.
- Accidents, injuries such as a car accident or a knife stab.
What are the causes of an aneurysm bursting?
There are several main risk factors for a splenic artery aneurysm to rupture:
- Portal hypertension: Increased blood flow to the area of the aneurysm increases the risk of rupture.
- Pregnancy: About 50% of aneurysms in pregnant women rupture during pregnancy. Most often, this rupture occurs in the last trimester of pregnancy.
- Presence of symptoms: People with symptoms have an 80% risk of developing an outbreak. This is much higher than those without symptoms (who have a 10% risk).
How do doctors diagnose this condition?
In fact, splenic artery aneurysms can be a bit difficult to diagnose. This is because the symptoms are not very clear, and they can mimic many other conditions. Sometimes, doctors discover this condition while performing tests for another reason.
Special imaging tests are the best way to detect these aneurysms, especially if you have no symptoms.
Here are some tests used for this:
- CT Angiography (Computed tomography angiography - CTA)
- Digital subtraction angiography (DSA)
- Ultrasound examinations (Ultrasonography) , including endoscopic ultrasound examinations.
- M.R. Angiography (Magnetic resonance angiography - MRA)
Each of these tests has specific benefits for detecting aneurysms and planning treatment. Your doctor will explain to you which tests you need and why.
How do I know if I need treatment?
Splenic artery aneurysms, which are at risk of bursting or rupturing, need to be treated quickly. If you have any of the following conditions, your doctor may recommend treatment:
- If the aneurysm is larger than 3 centimeters (30 millimeters) in diameter.
- If the aneurysm gets bigger over time .
- If you have symptoms .
- If you need a liver transplant .
- If you are pregnant , or if there is a possibility of pregnancy .
If your aneurysm is not at risk of rupture, your doctor will likely recommend surveillance , which means follow-up imaging tests at regular intervals. If your risk of rupture increases at any time, your doctor will recommend treatment.
What are the treatments for a splenic artery aneurysm?
There are several treatment options for this.
- Endovascular procedure: This is usually the best option for managing an aneurysm before it bursts (elective treatment). Here, the doctor blocks off the blood flow through the aneurysm. There are different methods for this. For example, in a method called 'coiling', metal coils are used to fill the aneurysm. In another method, a special liquid is injected, which thickens and stops the blood flow through the aneurysm. The doctor chooses the most suitable method depending on the shape and location of the aneurysm.
- Open surgery: This is recommended for people who cannot have endovascular treatment or who have not had success with it. Here, the doctor removes the damaged part of the artery. You may also need to have your spleen removed (splenectomy) .
- Laparoscopic procedure: This is a less invasive procedure than open surgery, and the recovery time is shorter. This is often the best option for treatment during pregnancy.
Talk to your doctor about which treatment plan is best for you.
Complications of treatment
Your doctor will explain to you the risks and complications of treatment. The most common of these is a condition called post-embolization syndrome (PES) . Symptoms of PES include:
- Fever.
- Nausea and vomiting.
- Stomach pain.
If you develop these symptoms after treatment, talk to your doctor. Your doctor may recommend painkillers or saline (IV fluids) to help relieve your symptoms until you recover.
What can I do to reduce this risk?
It is important to properly manage any other medical conditions you have, especially those that increase your risk of a splenic artery aneurysm. Talk to your doctor about what you need to do specifically for your condition.
Here are some common things you can do:
- Take all medications prescribed to you on time .
- If you develop any new symptoms or if your symptoms change, tell your doctor immediately .
- Attend annual medical checkups , and go to every scheduled appointment with the doctor.
Also, making certain lifestyle changes can help maintain the health of all your blood vessels , including your splenic artery.
- Stop smoking and tobacco use completely .
- Eat a heart-healthy diet .
- Exercise regularly as recommended by your doctor.
- Limit alcohol consumption .
If I have this condition, what should I expect? What is the outlook?
If you have a splenic artery aneurysm, follow your doctor's instructions carefully. You may not need treatment right away. Instead, your doctor may recommend what they call "watchful waiting." This means you will have regular imaging tests (usually every year) to see if the aneurysm is getting bigger. Timely treatment is essential to prevent an aneurysm from bursting or rupturing.
The outlook for someone with this condition depends on several factors:
- The size and location of the aneurysm.
- How fast the aneurysm grows .
- Whether the aneurysm will burst or not .
- Other medical conditions and risk factors you have.
Splenic artery aneurysm ruptures are often fatal . Research has shown that a rupture can be fatal in people who:
* Between 25% and 40% of non-pregnant women.
* Between 65% and 75% of pregnant women (fetal mortality rate between 90% and 95%).
* More than 50% of people with portal hypertension .
Ruptures of pseudoaneurysms of the splenic artery are almost always fatal .
Talk to your doctor about the outlook for your personal situation.
How can I take care of myself? When should I see a doctor?
Living with a splenic artery aneurysm can be a bit stressful . You may wonder what's going on inside your body, or you may be afraid that the aneurysm will burst.
It is normal to feel anxious. Share your feelings with your doctor. Your doctor may recommend proactive treatment for an aneurysm that is at risk of rupture. Ask your doctor to show you your imaging results and explain what they mean. The more involved you are in your health care, the more you will feel in control of your condition.
Your doctor will tell you how often you need to come in for check-ups and imaging tests. If you have any questions, concerns, or new or changing symptoms, call your doctor right away .
What questions should I ask my doctor?
Ask your doctor to explain your diagnosis and your treatment plan. Here are some questions you can ask:
- How big is my aneurysm?
- Where exactly is it?
- What is the chance of it exploding ?
- What symptoms should I look out for ?
- When should I talk to 1990 ?
- How often do I need to come for medical checkups ?
- What tests do I need to do? How should I prepare for them?
Also, ask your doctor about additional sources of information that can help you understand your diagnosis and treatment plan.
Final Take-Home Message
Like other aneurysms, splenic artery aneurysms are most dangerous if left untreated . If your doctor detects that you have this condition, you are already one step ahead. The doctor will monitor the condition and tell you when you need treatment.
If you are being treated for an aneurysm or rupture, it is important to be vigilant over the long term . Don't miss your doctor's appointments, and talk to your doctor about any new or changing symptoms. Be an active partner in your medical care and learn as much as you can about your condition. With knowledge and information, you can work with your medical team to help minimize future problems.
` Splenic Artery Aneurysm, Spleen, Artery, Abdominal Pain, Pregnancy, Blood Vessels
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