The Recognition and Incidence of Splenic Artery Anemysms

Abstract 275 spleens were examined by an initial plain film and then after injections of a slightly diluted water‐barium suspension. Of these specimens, 250 were normal size spleens and 25 enlarged. Splenic artery aneurysms were common and the vast majority had been asymptomatic. They commonly occurred at bifurcations and were commonly calcified. They were well embedded in the peri‐pancreatic or splenic hilar tissue and were not visible unless very large or the artery was dissected free from this surrounding tissue. The small splenic artery aneurysms are particularly common in elderly females and associated with arterial disease in the other branches of the splenic artery. In normal sized spleens intrasplenic aneurysms were not found, whereas intrasplenic aneurysms are common in enlarged spleens, particularly in markedly enlarged spleens associated with liver cirrhosis. Splenic artery aneurysms of the extrasplenic arteries are also commonly found to be associated with markedly enlarged spleens. The sex and age incidence of splenic artery aneurysms in the presence of splenic enlargement and/or liver cirrhosis differs markedly from that in the cases with normal sized spleens. In this group the sex incidence is about equal, and aneurysms occur most frequently in the under 50 year old group, whereas in the routine post‐mortem normal sized spleens, aneurysms occur in those over 50 years old and predominantly females. The injection of contrast material and the subsequent visualisation of the arterial pattern on a radiograph is an effective method of demonstrating these lesions. Moreover, the intrasplenic aneurysms will be completely missed unless an injection technique is used.