Document Detail


Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals.
MedLine Citation:
PMID:  20012950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm.
Authors:
Grace S Phillips; Nghia J Vo; Gisele E Ishak; Jonathan O Swanson; Randolph K Otto
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-12-15
Journal Detail:
Title:  Pediatric radiology     Volume:  40     ISSN:  1432-1998     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1278-80     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of Washington, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA. grace.phillips@seattlechildrens.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aneurysm / radiography*
Angiography / methods*
Collateral Circulation
Diagnosis, Differential
Humans
Male
Portal Vein / abnormalities*,  radiography*
Splenic Artery / radiography*
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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