Splenic Aneurysm Near the Origin of Splenic Artery and Splenic Hamartoma with Stricture of the Celiac Artery Due to Median Arcuate Ligament Compression

Abstract

We report a rare case of splenic aneurysm and splenic hamartoma with stricture of the celiac artery by median arcuate ligament compression. A 35-year-old man was found to have a splenic tumor on a medical examination. We diagnosed a splenic tumor and splenic aneurysm after further examination. At first, we planned laparoscopic splenectomy after embolization of the splenic aneurysm by interventional radiology (IVR), but we could not achieve embolization because of the median arcuate ligament compression. We chose laparotomy for release of the median arcuate ligament, and we continuously embolized the aneurysm by intraoperative IVR. Our hybrid operating room contributed to this procedure. We embolized the splenic artery without ischemia of the pancreatic body and tail by preserving the developed dorsal pancreatic artery. We could safely treat this complicated case, and we believe this experience can be very useful for future cases.