Mass Image in Stomach: A Case of Splenic Artery Aneurysm.

To the Editor: A 13-year-old girl had experienced abdominal pain and nausea for about 1 year, along with epigastric discomfort. An endoscopic intervention revealed a mass that protruded into the stomach lumen [Figure 1a]. A biopsy revealed normal gastric mucosa. Computed tomography (CT) indicated a mass of about 2 cm between the pancreatic tail, spleen, and stomach. CT angiography showed a 27 mm aneurysm dilatation in the first 3rd of the middle splenic artery [Figure 1b].

Figure 1

The protrusion effect of a mass seen endoscopically in the patient's stomach (fundus) lumen (a, arrows). Computed tomography angiography image of the splenic artery aneurysm (b, arrow).

Splenic artery aneurysms (SAAs) are the third most common true aneurysms occurring in the abdomen, after aortic and iliac artery aneurysms. SAAs are usually asymptomatic. Patients with symptomatic SAA can present with nausea and vague abdominal discomfort in the epigastric region or left upper quadrant, mimicking gastritis.[1] SAAs can be detected by imaging studies or endoscopic ultrasonography.[2] The rupture of a SAA is associated with severe abdominal pain and upper gastrointestinal bleeding in some cases.[3]

Most small (<2 cm) asymptomatic SAAs can be monitored effectively with serial imaging.[1] However, in our case, the aneurysm was resected and an end-to-end anastomosis of the splenic artery was performed because the aneurysm was >2 cm and was symptomatic.

Declaration of patient consent

The authors certify that they have obtained appropriate patient consent form. In the form, the patient's parents have given their consent for the patient's images and other clinical information to be reported in the journal. The patient's parents understand that name and initial will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.