The development and clinical features of splenic aneurysm associated with liver cirrhosis
The development and clinical features of splenic aneurysm associated with liver cirrhosis
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DOI：
10.1111/j.1478-3231.2005.01231.x
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发表时间：
2006-04-01
影响因子：
6.7
通讯作者：
Kaneko, S
中科院分区：
文献类型：
--
作者：
Sunagozaka, H;Tsuji, H;Kaneko, S
目的：脾动脉瘤（SAA）通常无症状，但如果破裂可能致命。伴有静脉曲张或脾肿大的门脉高压患者有时会并发SAA。然而，无论静脉曲张还是脾肿大，肝硬化本身是否与脾动脉瘤相关，目前还没有大规模的临床研究。方法：在本研究中，我们回顾性分析了 303 例接受动脉造影检查的肝硬化患者。确定SAA的诊断和特征，并评估其与脾动脉直径的关系。结果：9 名患者（2.97%）有 12 种复杂的 SAA。动脉瘤直径4~22 mm，均为囊状，多见于脾门（50.0%）。脾动脉直径和动脉瘤直径之间存在相关性（R-2 = 0.706）。动脉瘤的生长与脾动脉干直径的增加密切相关（R-2 = 0.705），而脾动脉干的直径与动脉血流密切相关。结论：SAA 被认为是肝硬化的并发症。脾动脉直径的增加可能导致 SAA 扩大和破裂。除了 SAA 大小（动脉瘤破裂的已知危险因素）之外，还应根据对脾动脉主干或直径的随访来考虑选择性手术。
Objectives: Splenic artery aneurysm (SAA) is usually asymptomatic, but can be fatal if it ruptures. Portal hypertensive patients with varix or splenomegaly are sometimes complicated by SAA. However, there have been no large-scale clinical studies regarding whether liver cirrhosis itself is associated with splenic aneurysm regardless of varix or splenomegaly. Methods: In the present study, we retrospectively analyzed 303 cirrhotic patients examined with arteriography. The diagnosis and characteristics of SAAs were determined, and the relation with splenic artery diameter was evaluated. Results: Nine patients (2.97%) had 12 complicated SAAs. The aneurysms, which measured 4-22 mm in diameter, were all saccular, and occurred commonly in the splenic hilum (50.0%). A correlation was noted between splenic artery diameter and aneurysm diameter (R-2 = 0.706). Aneurysm growth was strongly associated with an increase in diameter of the splenic artery trunk (R-2 = 0.705), which is closely related to arterial flow. Conclusions: SAA is considered a complication of cirrhosis. The increase in splenic artery diameter may result in SAA enlargement and rupture. Elective procedures should be considered based on the follow-up of main trunk or diameter of the splenic artery in addition to SAA size, a known risk factor of aneurysmal rupture.