Delayed presentation of a traumatic splenic artery pseudoaneurysm in an initially normal spleen: Case study and review of literature

Abstract

Background: Blunt injury of the spleen is common and with the shift towards nonoperative management in haemodynamically stable patients, the delayed development of splenic artery pseudoaneurysms are of great concern. Management traditionally involves angioembolisation with the intent to preserve splenic function; however recent studies suggest that this is not without complication.
Case presentation: We present a rare case of delayed splenic pseudoaneurysm arising 6 days post motorbike accident, with initial computerised tomography showing no evidence of splenic injury. The patient was successfully embolised and progressed well without complication. No clear cause was found for his development of splenic injury.
Conclusions: Splenic artery pseudoaneurysms are not uncommon and necessitate follow-up imaging after nonoperative management of blunt splenic trauma. Once diagnosed, embolisation versus conservative management can be considered on a case-by-case basis.