Hemodynamic study of splenic artery aneurysm in portal hypertension.

In our ongoing studies on the hemodynamics of splenic artery aneurysms (SAA) in portal hypertension, 32 patients with portal hypertension were examined by duplex sonography and angiography. Four out of 32 (12.5%) had SAA, and SAA(+) and SAA(-) groups were formed. On duplex sonography, splenic venous blood flow in the SAA(+) group (1058 +/- 211 ml/min) increased more than in the SAA(-) group (423 +/- 173 ml/min, p < 0.01), but there was no significant difference in portal venous flow. On angiography, there were significant differences in the diameters of the splenic arteries between the SAA(+) group (7.5 +/- 0.5 mm) and the SAA(-) group (5.6 +/- 1.0 mm, p < 0.01). All patients (100%) in the SAA(+) group had prominent portosystemic shunts, while 8 out of 28 (28.6%) in the SAA(-) group had these shunts (p < 0.05). Thus, there seems to be a splenic hyperkinetic state in patients with SAA and portal hypertension, a finding which may closely relate to the pathogenesis of SAA.