Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Rupture of visceral artery aneurysm following elective spinal surgery: a case report and review

  • 26 Accesses

Abstract

Introduction

Visceral artery aneurysms (VAA), an uncommon disorder of splanchnic vasculature, are associated with significant morbidity and mortality. Despite largely being amenable to endovascular therapies, the initial management of symptomatic VAA typically falls under the care of general surgeons. It is thus essential to have knowledge of the diagnosis and treatment of VAA and to be cognisant of deviations from normal gastrointestinal vasculature.

Case presentation

In this paper, we describe the case of a 72-year-old male presenting with a VAA following elective spinal surgery, followed by a review of the clinical diagnosis and management of VAA.

Conclusion

Visceral artery aneurysm must be considered as a differential diagnosis for acute abdominal pain and anaemia in the post-operative period following all major operations. Knowledge of the clinical features of VAA and indications for specific intervention are essential for all general surgeons. Furthermore, it is imperative to recognise deviations from normal vasculature of the gastrointestinal tract.

Trial registration

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. 1.

    Pasha SF, Gloviczki P, Stanson AW, Kamath PS (2007) Splanchnic artery aneurysms. Mayo Clin Proc 82(4):472–479. https://doi.org/10.4065/82.4.472

  2. 2.

    Pitton MB, Dappa E, Jungmann F, Kloeckner R, Schotten S, Wirth GM, Mittler J, Lang H, Mildenberger P, Kreitner KF, Oberholzer K, Dueber C (2015) Visceral artery aneurysms: incidence, management, and outcome analysis in a tertiary care center over one decade. Eur Radiol 25(7):2004–2014. https://doi.org/10.1007/s00330-015-3599-1

  3. 3.

    Hemp JH, Sabri SS (2015) Endovascular management of visceral arterial aneurysms. Tech Vasc Interv Radiol 18(1):14–23. https://doi.org/10.1053/j.tvir.2014.12.003

  4. 4.

    Tetreau R, Beji H, Henry L, Valette PJ, Pilleul F (2016) Arterial splanchnic aneurysms: presentation, treatment and outcome in 112 patients. Diagn Interv Imaging 97(1):81–90. https://doi.org/10.1016/j.diii.2015.06.014

  5. 5.

    Regus S, Lang W (2016) Rupture risk and etiology of visceral artery aneurysms and pseudoaneurysms: a single-center experience. Vasc Endovasc Surg 50(1):10–15. https://doi.org/10.1177/1538574415627868

  6. 6.

    Branchi V, Meyer C, Verrel F, Kania A, Bolke E, Semaan A, Koscielny A, Kalff JC, Matthaei H (2019) Visceral artery aneurysms: evolving interdisciplinary management and future role of the abdominal surgeon. Eur J Med Res 24(1):17–19. https://doi.org/10.1186/s40001-019-0374-9

  7. 7.

    Shukla AJ, Eid R, Fish L, Avgerinos E, Marone L, Makaroun M, Chaer RA (2015) Contemporary outcomes of intact and ruptured visceral artery aneurysms. J Vasc Surg 61(6):1442–1447. https://doi.org/10.1016/j.jvs.2015.01.005

  8. 8.

    Ibrahim F, Dunn J, Rundback J, Pellerito J, Galmer A (2018) Visceral artery aneurysms: diagnosis, surveillance, and treatment. Curr Treat Options Cardiovasc Med 20(12):97. https://doi.org/10.1007/s11936-018-0696-x

  9. 9.

    Madhusudhan KS, Venkatesh HA, Gamanagatti S, Garg P, Srivastava DN (2016) Interventional radiology in the management of visceral artery pseudoaneurysms: a review of techniques and embolic materials. Korean J Radiol 17(3):351–363. https://doi.org/10.3348/kjr.2016.17.3.351

  10. 10.

    Chin JA, Heib A, Ochoa Chaar CI, Cardella JA, Orion KC, Sarac TP (2017) Trends and outcomes in endovascular and open surgical treatment of visceral aneurysms. J Vasc Surg 66(1):195–201 e191. https://doi.org/10.1016/j.jvs.2017.02.036

  11. 11.

    Batagini NC, El-Arousy H, Clair DG, Kirksey L (2016) Open versus endovascular treatment of visceral artery aneurysms and pseudoaneurysms. Ann Vasc Surg 35:1–8. https://doi.org/10.1016/j.avsg.2016.01.035

  12. 12.

    Corey MR, Ergul EA, Cambria RP, English SJ, Patel VI, Lancaster RT, Kwolek CJ, Conrad MF (2016) The natural history of splanchnic artery aneurysms and outcomes after operative intervention. J Vasc Surg 63(4):949–957. https://doi.org/10.1016/j.jvs.2015.10.066

  13. 13.

    Cochennec F, Riga CV, Allaire E, Cheshire NJ, Hamady M, Jenkins MP, Kobeiter H, Wolfe JN, Becquemin JP, Gibbs RG (2011) Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg 42(3):340–346. https://doi.org/10.1016/j.ejvs.2011.04.033

  14. 14.

    van Rijn MJ, Ten Raa S, Hendriks JM, Verhagen HJ (2017) Visceral aneurysms: old paradigms, new insights? Best Pract Res Clin Gastroenterol 31(1):97–104. https://doi.org/10.1016/j.bpg.2016.10.017

Download references

Acknowledgements

The authors would like to thank Dr. Ravi Kumar Muli Jogi of SKG radiology for his assistance in providing interpretation of imaging for this project.

Author information

Correspondence to Nelson Smith.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

Not applicable

Consent to participate

Consent has been obtained from the patient to publish their de-identified case details and to utilise their imaging for the purposes of publication and presentation.

Availability of data and material

Not applicable

Code availability

Not applicable

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smith, N., Cohen, R. & Chetrit, S. Rupture of visceral artery aneurysm following elective spinal surgery: a case report and review. Int J Colorectal Dis (2020). https://doi.org/10.1007/s00384-020-03531-z

Download citation

Keywords

  • Visceral artery
  • Aneurysm
  • Superior mesenteric artery
  • Diagnosis and management
  • Surgical therapy
  • Endovascular therapy