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Image of the Month—Diagnosis
Arch Surg. 2006;141:1142.
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Answer: Splenic Artery Pseudoaneurysm
The CT scan demonstrated 2 hypodense lesions in the spleen. The most superior lesion contains prominent vessels with focus of high attenuation, which may represent active bleeding from an arteriovenous fistula, a splenic aneurysm, a splenic pseudoaneurysm, or a hemangioma. Celiac angiography showed a pseudoaneurysm of a peripheral branch of the splenic artery in the upper pole of the spleen (Figure 2) that was embolized with 3-mm coils. No residual filling was seen after embolization. The patient tolerated the procedure well and was discharged home 2 days later.
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Figure 2. Celiac artery angiogram.
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Because traumatic pseudoaneurysms are rare, with only 45 reported cases,1 the clinical profile of this condition is not well defined. Most traumatic splenic pseudoaneurysms result from blunt trauma. Abdominal pain is the most common symptom, although initial findings may range from an incidental radiographic finding to acute hemodynamic instability. The majority (74%) of traumatic splenic . . . [Full Text of this Article]
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Image of the Month—Quiz Case
Asaf A. Gave, Spiros G. Frangos, Heidi Frankel, and Reuven Rabinovici
Arch Surg. 2006;141(11):1141.
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