Chap 141 Splanchnic Aneurysms Flashcards Preview

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Flashcards in Chap 141 Splanchnic Aneurysms Deck (14):
1

What are some common cause of splanchnic aneurysms?

athero
FMD
CTD
inflammatory conditions
iatrogenic

2

What are the most common aneurysms?

splenic
hepatic
SMA
celiac
Gastric

3

Which have the highest rupture rate?

GAA 90%
HAA 20-40%
CAA 10%
SPA
high in pregnancy

4

Which have the highest mortality with rupture?

CAA SPAA 75% in pregnancy
fetal 85%
rest >10%

5

What disease has high incidence of SA?

polyarteritis nodosa

6

What is the double rupture?

1st into lesser sac
2nd intraperitoneal

7

What are X-ray findings of splenic artery aneurysm?

70% curvilinear signet ring of calcification

8

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)

9

At what level can you ligate splenic?

prod-mid
collaterals from short gastric

10

Why is HAA incidence increasing?

conservative management of blunt liver trauma and biliary procedures

11

What is HAA triad?

abdo pain
hematobilia
obstructive jaundince

12

When can you ligate a HAA?

if there is a patent GDA

13

Where are SMAA usually located?

first 5 cm

14

What are indications for intervention on SMAA?

no size per se
false aneurysm