Massive lower gastrointestinal bleeding from a splenic artery aneurysm a case report and review of the literature

Splenic Artery Aneurysms (SAAs) are the most common type of abdominal visceral artery aneurysm. Most of the splenic artery aneurysm is asymptomatic, being found incidentally at the time of investigations or surgery. Complications of SAAs include free intraperitoneal rupture and erosion into abdominal viscera or vessels, such as pancreatic duct, esophagus, stomach, or large bowel, which can results in gastrointestinal bleeding or arteriovenous fistula and associated with high morbidity and mortality. Treatment of such aneurysms depends on the patient general condition, presentation and location of the aneurysm in relation to the spleen, and the known morbidities for each procedure. Treatment options include open surgery, laparoscopic surgery, and endovascular stent graft and transcatheter embolization. The present case is the first, to our knowledge, of true SAA presenting with massive lower gastrointestinal bleeding from erosion into colon treated successfully with transcatheter arterial embolization with no recurrent of gastrointestinal bleeding in ten months follow-up.