Top

International Journal of Colorectal Disease

Published in:

01-04-2020 | Aneurysm | Case Report

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

Authors: Nelson Smith, Ryan Cohen, Stephanie Chetrit

Published in: International Journal of Colorectal Disease | Issue 4/2020

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

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 CrossRefPubMed

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 CrossRefPubMedPubMedCentral

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 CrossRefPubMed

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 CrossRefPubMed

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 CrossRef

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 CrossRefPubMedPubMedCentral

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 CrossRefPubMed

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 CrossRefPubMed

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 CrossRefPubMedPubMedCentral

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 CrossRefPubMed

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 CrossRefPubMed

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 CrossRefPubMed

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 CrossRefPubMed

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 CrossRefPubMed

Title: Rupture of visceral artery aneurysm following elective spinal surgery: a case report and review
Authors: Nelson Smith
Ryan Cohen
Stephanie Chetrit
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Aneurysm
Aneurysm
Spinal Surgery
Key Symptom
Abdominal Pain
Published in: International Journal of Colorectal Disease / Issue 4/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03531-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Introduction

Case presentation

Conclusion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

Trial registration

Please log in to get access to this content

Other articles of this Issue 4/2020

Risk factors and therapeutic significance of inguinal lymph node metastasis in advanced lower rectal cancer

Lower peripouch fat area is related with increased frequency of pouch prolapse and floppy pouch complex in inflammatory bowel disease patients

Treatment of chronic anal fissure: a feasibility study on Levorag® Emulgel versus Diltiazem gel 2%

Ileal pouch–anal anastomosis in ulcerative colitis: outcomes, functional results, and quality of life in patients with more than 10-year follow-up

Is aflibercept an optimal treatment for wt RAS mCRC patients after progression to first line containing anti-EGFR?

The bacterial instrument as a promising therapy for colon cancer