Chap 141 Splanchnic Aneurysms Flashcards
What are some common cause of splanchnic aneurysms?
athero FMD CTD inflammatory conditions iatrogenic
What are the most common aneurysms?
splenic hepatic SMA celiac Gastric
Which have the highest rupture rate?
GAA 90% HAA 20-40% CAA 10% SPA high in pregnancy
Which have the highest mortality with rupture?
CAA SPAA 75% in pregnancy
fetal 85%
rest >10%
What disease has high incidence of SA?
polyarteritis nodosa
What is the double rupture?
1st into lesser sac
2nd intraperitoneal
What are X-ray findings of splenic artery aneurysm?
70% curvilinear signet ring of calcification
What are indication to operate on splenic AA?
Symptomatic Rupture Enlarging (10% of patients) >2cm (not absolute) Pregnant or childbearing age Portal HTN or liver transplant list False aneurysm regardless of size (Cleveland Clinic)
At what level can you ligate splenic?
prod-mid
collaterals from short gastric
Why is HAA incidence increasing?
conservative management of blunt liver trauma and biliary procedures
What is HAA triad?
abdo pain
hematobilia
obstructive jaundince
When can you ligate a HAA?
if there is a patent GDA
Where are SMAA usually located?
first 5 cm
What are indications for intervention on SMAA?
no size per se
false aneurysm
