DAS KOMPLIZIERTE LIENALIS-ANEURYSMA

: For 2 1/2 years after sustaining blunt trauma to the abdomen a 51-year-old woman had experienced episodes of pain, recently with throbbing, in the left upper quadrant. A smooth, circumscribed, painless tumour filling the left upper and mid-abdomen was palpable under the left costal margin. Ultrasound revealed a 12 x 11 cm space-occupying mass with cystic-fluid components, at first interpreted as a blood-containing pseudocyst. Computed tomography demonstrated a connection with the splenic artery. Digital subtraction angiography established the diagnosis of an aneurysm of the splenic artery arising immediately beyond its origin from the coeliac trunk. Splenectomy and resection of the aneurysm were performed. Total removal of the aneurysm was not undertaken because the dorsal aspect of the aneurysm wall was very thick and fused with the retroperitoneum. The postoperative course was unremarkable. The genesis of splenic aneurysm often remains unexplained. Its occurrence after blunt abdominal trauma is exceedingly rare.