The diagnosis and management of visceral artery aneurysms

Ronald W. Busuttil, Barbara J. Brin

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204 Scopus citations

Abstract

Both the diagnosis and treatment of visceral artery aneurysms are difficult. During the past 22 years at the UCLA Hospital, 21 patients have been treated for visceral artery aneurysms. Eleven of the patients were men and 10 were women. They ranged in age from 13 to 77 years. Of the 21 patients, 10 were symptomatic and 11 were asymptomatic. Multiple aneurysms, found in 36% of the patients, typically involved the hepatic artery in combination with the gastroduodenal or celiac artery. Aneurysms arose from the splenic artery in 10 patients, from the hepatic artery in 10 patients, and from other visceral arteries in one. Factors relevant to the pathogenesis of these aneurysms included: atherosclerosis, periarteritis nodosa, and fibromuscular dysptasia, as well as other causes. Fifty percent of patients with splenic artery aneurysms were symptomatic. One death occurred secondary to a delay in diagnosis. Sixty percent of hepatic artery aneurysms were symptomatic, and two thirds of these patients died of causes directly attributable to the aneurysm. Among women with symptomatic splenic artery aneurysms, half had completed more than six pregnancies. Periarteritis nodosa developed in one third of patients with symptomatic hepatic artery aneurysms. Rupture occurred in four patients, three with hepatic artery aneurysms and one with splenic artery aneurysms. Diagnosis was established preoperatively in 76% of the patients by plain abdominal x-rays and visceral angiography. Surgical treatment for visceral artery aneurysms is indicated in any symptomatic patient, in women of child-bearing age who have splenic artery aneurysms regardless of size, and in all patients with surgically accessible hepatic artery aneurysms.

Original languageEnglish (US)
Pages (from-to)619-624
Number of pages6
JournalSurgery (United States)
Volume88
Issue number5
StatePublished - 1980

ASJC Scopus subject areas

  • Surgery

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