ANEURYSMS OF ANOMALOUS SPLENOMESENTERIC TRUNK - CLINICAL-FEATURES ANDSURGICAL-MANAGEMENT IN 2 CASES

Aneurysms of the splenic artery that anomalously arise from a splenome senteric trunk are a rarity. Aneurysmal disease of visceral arteries i s found in only 0.2% of the general population. The celiac trunk and s uperior mesenteric artery (SIMA) are involved in less than 10% of all visceral aneurysms. Although rupture seems to occur in 20% to 22% of p atients, the related mortality rate can rise as high as 100%. Anomalie s of the celiac trunk and SMA, more common than previously claimed, in clude the splenic artery arising from the SMA, which occurs in only 1% of patients. We present two cases of young patients who had 4-cm aneu rysms behind the pancreas that involved an anomalous splenic artery. T he first patient required dissection of the entire splenopancreatic bl oc through a transverse abdominal incision to excise the aneurysm and repair the SMA. The second patient was treated by the classic approach , through a median incision and by entering the mesenteric root. There do not seem to be reports of similar cases, except for two cases of a neurysms involving the celiomesenteric trunk. The cause of these aneur ysms can be attributed to mesenchymal alterations during the embryonic formation of aortic collateral branches. A correct surgical approach to splanchnic aneurysms calls for awareness of potential vascular vari ations of the arteries and their collateral pathways.