A Case of Isolated Spontaneous Celiac Artery Dissection with Rupture of a Proximal Splenic Arterial Aneurysm

Abstract

A 34-year-old man was transported by ambulance to our emergency room following a fall down some stairs in his home due to loss of consciousness. He was in shock, and a contrast CT scan showed dissection of the celiac artery and rupture of an aneurysm of the splenic artery with active bleeding. Intra-aortic balloon occlusion (IABO) was performed and an emergency operation was carried out. The control of hemorrhage by IABO was effective, and we could ligate both the proximal and distal splenic arteries associated with the splenic aneurysm. The total balloon occlusion time was 55 minutes and the total bleeding volume was 8,652 mL. Because of hypothermia and acidosis, the operation was finished without splenectomy. The contrast CT scan taken on the following day showed good collateral blood flow in both the splenic artery and common hepatic artery. The patient was discharged in good condition on the 15th postoperative day. Splenic aneurysm rupture related to isolated spontaneous celiac artery dissection has been rarely reported, and preoperative IABO insertion was effective for hemorrhage control of the splenic aneurysm rupture.