Post-traumatic intrasplenic pseudoaneurysms with delayed rupture: Color Doppler sonographic and CT findings

Post-traumatic intrasplenic pseudoaneurysms are very rare in children. Sinc e pseudoaneurysms may expand a splenic hematoma and cause delayed splenic r upture, early diagnosis and treatment a re crucial. In this report, we desc ribe the case of a 12-year-old boy with a delayed splenic rupture caused by a splenic hematoma containing 2 pseudoaneurysms. Abdominal sonography show ed free intraperitoneal fluid and a mildly enlarged spleen with a large het erogeneous area occupying the upper half of the organ. Two anechoic lesions (15 and 4 mm) were seen inside the hematoma near the splenic hilum. Color Doppler sonography demonstrated turbulent arterial flow within the lesions, suggesting pseudoaneurysms. On CT, the lesions enhanced simultaneously wit h the splenic artery in the arterial phase of contrast enhancement. CT also showed an intrasplenic arterial branch leading to the larger of the 2 pseu doaneurysms. (C) 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:102-104, 2001.