It’s a funny thing, how our bodies can be working away, keeping secrets. Sometimes, a little problem can be brewing inside, quiet as a mouse, and we’re none the wiser. That can be the case with something called a Splenic Artery Aneurysm. You might not have even heard of it, and honestly, many folks haven’t until it touches their lives or someone they know.
What Exactly Is a Splenic Artery Aneurysm?
Alright, let’s break this down. Your spleen is an organ tucked up under your left ribs, and like all organs, it needs a good blood supply. The splenic artery is the road that blood takes to get there. Now, an aneurysm is essentially a bulge or a weak spot that balloons out in the wall of an artery. Think of an old garden hose that gets a little bubble on the side – that’s kind of the idea. So, a Splenic Artery Aneurysm is simply this bulge happening in the artery going to your spleen. For doctors to call it an aneurysm, this bulge usually needs to be about 1 centimeter (that’s a bit less than half an inch) or bigger.
These aren’t super common, thankfully, affecting maybe 1 in 1,000 to 1 in 2,500 people. But they are the most frequent type of aneurysm we see in the arteries within the abdomen (we call these visceral artery aneurysms).
Who Tends to Get These?
While they can pop up in adults of various ages, we see them more often in women – nearly 80% of cases are in females. Being over 60 also seems to be a factor.
The tricky part? A Splenic Artery Aneurysm might not cause any symptoms at all for a long, long time. Or, it could suddenly make itself known in a very dramatic, emergency kind of way. That’s why knowing about it, especially the risks, is so important.
How Does This Affect Your Body, and How Serious Is It?
Normally, your arteries are pretty flexible, expanding and contracting with each heartbeat. But with an aneurysm, that one spot is stretched thin and weak. Over time, these can grow. And the bigger they get, the more dangerous they become.
Why dangerous? Because the main worry is that it could rupture (break open) or dissect (tear). If that happens, it’s a medical emergency, plain and simple, and can be life-threatening. This is especially true during pregnancy, which we’ll talk more about.
There’s also something called a pseudoaneurysm, or “false aneurysm.” This is where just one or two layers of the artery wall are affected, not all of them like in a “true” aneurysm. Sounds less dramatic, but these can actually be even more likely to rupture. So, yes, a Splenic Artery Aneurysm is a serious thing we need to respect.
What Might You Feel? Unpacking Symptoms of Splenic Artery Aneurysm
Many people, like I said, feel absolutely nothing. Zero. But if symptoms do show up, they might be a bit vague:
- A nagging pain in the upper left part of your belly. Sometimes this pain can feel like it’s spreading up to your left shoulder.
- A strange pulsating feeling in that same upper left belly area.
Now, if the aneurysm ruptures, the signs are sudden and severe. This is when you need to call for emergency help immediately (like 911):
- Sudden, intense pain in your upper belly, just below your ribs.
- Pain in your left shoulder (this is a classic sign of spleen irritation).
- Feeling incredibly nauseous or vomiting.
- Signs of hypovolemic shock – things like feeling dizzy, faint, cold and clammy skin, rapid heartbeat, confusion. This means there’s serious internal bleeding.
Sometimes, a rupture happens in two stages. You might get hit with sudden symptoms, then feel a bit better for a short while. Don’t let that fool you; it’s often the calm before the storm, and shock can set in quickly after. If you have any of these sudden symptoms, please, get medical help right away.
What Causes These Aneurysms to Form or Rupture?
It boils down to a weakness in the wall of that splenic artery. What causes that weakness? Well, we don’t always know the exact trigger for every person. But we do know some pretty strong risk factors.
Key Risk Factors for Formation:
One of the biggest ones we see in my practice is pregnancy. Hormonal shifts during pregnancy can affect blood flow and put extra pressure on the splenic artery, weakening its walls. And if you’ve had multiple pregnancies, the risk can go up.
Other medical conditions can also play a role:
- Arterial hypertension (that’s high blood pressure).
- Atherosclerosis (hardening of the arteries).
- Having a brain aneurysm elsewhere.
- Cirrhosis of the liver.
- Certain connective tissue diseases, like Marfan syndrome.
- Diabetes.
- Endocarditis (an infection of the heart lining).
- Fibromuscular dysplasia (FMD) (a condition causing abnormal cell growth in artery walls).
- Granulomatosis with polyangiitis (GPA).
- History of liver transplantation.
- Polyarteritis nodosa (PAN) (a type of vasculitis).
- Portal hypertension (high blood pressure in the veins around the liver, often linked to liver disease).
- Vasculitis (inflammation of blood vessels).
For pseudoaneurysms (the “false” ones), common culprits include:
- Chronic pancreatitis (long-term inflammation of the pancreas).
- Complications from surgery in that area.
- Trauma, like from a car accident or a stab wound.
What Makes Them Rupture?
Not every aneurysm will rupture, but some things definitely increase the odds:
- Portal hypertension: More blood flow and pressure near the aneurysm isn’t a good mix.
- Pregnancy: This is a big one. About half of aneurysms in pregnant women rupture, usually in the last trimester. It’s a very serious situation for both mom and baby.
- Having symptoms: If you’re already feeling pain or other signs from the aneurysm, the risk of it rupturing is much higher (around 80%) compared to someone with no symptoms (closer to 10%).
How Do We Find Out If You Have One? Diagnosis and Tests
Diagnosing a Splenic Artery Aneurysm can be tricky, especially if you don’t have symptoms. The signs can be so general they could point to a dozen other things. You know, sometimes we stumble upon these almost by accident when we’re doing scans for a completely different reason.
Imaging tests are our best bet for spotting these, particularly the silent ones.
Tests We Might Use:
To get a good look, we might suggest:
- Computed Tomography Angiography (CTA scan): This uses X-rays and a special dye to create detailed pictures of your blood vessels.
- Digital Subtraction Angiography (DSA): This is a bit more invasive, often used if we’re considering treatment. A catheter is inserted, dye is injected, and X-rays are taken.
- Ultrasonography: This uses sound waves. An endoscopic ultrasound (where a small ultrasound probe is passed down your throat on a thin tube) can sometimes give us a really close look.
- Magnetic Resonance Angiography (MRA): Similar to an MRI, this uses magnets and radio waves to see the blood vessels.
Each test has its pros and cons, and we’ll chat about which one is right for you and why.
Figuring Out Treatment: What’s Next?
If we do find a Splenic Artery Aneurysm, the first thing is not to panic. We need to figure out how likely it is to cause trouble.
When is Treatment Usually Recommended?
We’ll likely talk about treatment if:
- The aneurysm is on the larger side, say bigger than 3 centimeters (around 1.2 inches).
- We see that the aneurysm is growing over time on follow-up scans.
- You’re experiencing symptoms from it.
- You’re someone who needs a liver transplant.
- You’re pregnant or might become pregnant. This is a really important one due to the high rupture risk.
If your aneurysm is small, not growing, and not causing symptoms, we might go with “watchful waiting.” This means regular check-ups and imaging to keep an eye on things. If the risk goes up, then we’ll move to treatment.
What Are the Treatment Options?
We have a few ways to tackle these:
- Endovascular procedure: This is often our first choice for aneurysms that haven’t ruptured. It’s less invasive. The goal is to block off the aneurysm so blood can’t flow into it and make it burst. We can do this in a few ways, like “coiling,” where tiny metal coils are packed into the aneurysm. Or we might inject a special liquid that hardens and seals it off. We’ll pick the best technique based on where the aneurysm is and its shape.
- Open surgery: This is a more traditional surgery. We’d recommend this if endovascular treatment isn’t possible or hasn’t worked. The surgeon removes the damaged part of the artery. Sometimes, the spleen might also need to be removed (this is called a splenectomy).
- Laparoscopic procedure: This is a less invasive type of surgery than open surgery, using small incisions and a camera. Recovery is usually easier. It’s often a good option if treatment is needed during pregnancy.
We’ll sit down and discuss all the options, making sure you understand the plan that’s best for you.
What About Complications from Treatment?
Like any medical procedure, there can be complications. One common one after endovascular treatment is something called post-embolization syndrome (PES). You might experience:
- Fever
- Nausea and vomiting
- Pain in your belly
If you have these symptoms after your procedure, give us a call. We can usually manage them with pain medication or IV fluids.
What’s the Outlook?
Your outlook with a Splenic Artery Aneurysm really depends on a few things:
- The size and location of the aneurysm.
- How quickly it’s growing, if at all.
- Whether it ruptures or not – this is the big one.
- Any other medical conditions you have.
Now, I need to be honest here. If one of these aneurysms does rupture, it’s very serious. Statistics show a rupture can be fatal for:
- About 25% to 40% of non-pregnant women.
- About 65% to 75% of pregnant women (and sadly, the fetal mortality rate is very high, around 90% to 95%). This is why we are so vigilant during pregnancy.
- Over 50% of people who also have portal hypertension.
And for pseudoaneurysm ruptures, the outlook is even more grave, almost always being fatal.
These numbers are sobering, and it’s why early detection and management are key. We’ll always discuss your specific situation and what it means for you.
Can You Prevent Splenic Artery Aneurysms?
While we can’t always prevent them from forming, managing any underlying medical conditions is crucial. If you have high blood pressure, diabetes, liver disease, or any of the other risk factors we talked about, working closely with your doctor to keep those well-controlled is so important.
- Take your medications just as prescribed.
- Let your doctor know about any new or changing symptoms right away.
- Keep up with your regular check-ups and any recommended follow-up tests.
And those lifestyle choices we’re always talking about? They matter here too, for the health of all your blood vessels:
- If you smoke, please try to quit. We have resources to help.
- Aim for a heart-healthy diet – lots of fruits, veggies, whole grains, lean protein.
- Get regular exercise, whatever your doctor says is safe for you.
- Keep alcohol consumption moderate.
Living With a Splenic Artery Aneurysm
Hearing you have an aneurysm, even a small one, can be stressful. You might worry about it, wonder if it’s growing, or fear it might rupture. That’s completely normal.
Share these feelings with your doctor. If we’re in a “watchful waiting” phase, ask to see your scans, ask questions. Understanding what’s going on can actually make you feel more in control. And remember, if an aneurysm looks like it might become a problem, we’ll recommend proactive treatment to prevent that rupture.
Keep your follow-up appointments. They are so important. And call your doctor if you have any questions, concerns, or notice any new or worsening symptoms.
Take-Home Message: Key Points on Splenic Artery Aneurysm
Alright, let’s sum up the most important bits about Splenic Artery Aneurysm:
- It’s a bulge in the artery supplying your spleen, often silent until it’s serious.
- Women, especially during pregnancy or after multiple pregnancies, and those over 60 are at higher risk.
- The biggest danger is rupture, which is a life-threatening emergency.
- Symptoms, if any, can include left upper belly pain (maybe radiating to the shoulder) or a pulsating feeling. Sudden, severe pain, nausea/vomiting, and shock signs mean immediate emergency care.
- Diagnosis is usually through imaging tests like CTA or MRA.
- Treatment depends on size, growth, symptoms, and if you’re pregnant. Options include endovascular repair, open surgery, or laparoscopic surgery.
- Managing underlying conditions like high blood pressure and portal hypertension is vital.
A Final Thought
This might all sound a bit overwhelming, but please know you’re not alone in figuring this out. We’re here to explain things, answer your questions, and walk with you every step of the way. Don’t hesitate to reach out.