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Everything you need to know about Computed Tomography (CT) & CT Scanning

MDCT of the Spleen: Splenic Artery Aneurysm


The splenic artery is the most common location for visceral artery aneurysms (60%). Etiology is variable but potential causes include medial degeneration with superimposed atherosclerosis, mycotic, congenital, pancreatitis, portal hypertension and trauma. There is a 4:1 female to male ratio. Woman having two or more children are at increased, as are individuals with fibromuscular disease such as Ehlers Danlos syndrome.

Splenic artery aneurysms are often asymptomatic but may present with pain or gastrointestinal bleeding. There is a 6-9% chance of rupture with 76% mortality. The risk of rupture increases during pregnancy. Aneurysms requiring treatment are those that are symptomatic, enlarging, associated with pregnancy, or are >2 cm in diameter.

On CT, splenic aneurysms appear as focal enlargement of the splenic artery. Two-thirds have a peripherally calcified wall, which decrease the risk of rupture. Aneurysms may develop anywhere along the course of the vessel appearing as intra or extrasplenic. 70% of splenic artery aneurysms are solitary with 80% occurring in the distal third of the vessel. Differential considerations include tortuosity of the splenic artery mimicking an aneurysm and aneurysms of the adjacent renal artery.



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