Date of Presentation
5-2-2024 12:00 AM
College
Rowan-Virtua School of Osteopathic Medicine
Poster Abstract
Background: Splenic artery aneurysms most commonly present with vague epigastric or left upper quadrant abdominal pain that may radiate to the left shoulder. Chest pain associated with splenic artery aneurysm is an unusual phenomena. This case presents a rare occurrence of a splenic artery aneurysm originally presenting as atypical chest pain. Case Presentation: A 46 year old G3P2 AAF patient with family history of hypertension presented to the ER with pleuritic left chest pain, episodes of shortness of breath, and new onset hypertension. Chest x-ray and ECG were unremarkable. Pertinent labs included a hemoglobin of 10.6 and D-dimer of 4.10. CTA of the chest revealed no evidence of pulmonary embolism. Bilateral ultrasound of the lower extremities was negative for deep vein thrombosis. Following her negative workup, the patient’s symptoms were presumed to be related to allergies or asthma, although there was no symptomatic improvement with albuterol inhaler. Following discharge, the patient’s symptoms persisted and began to present as left upper quadrant abdominal pain with fullness. CT of the abdomen and pelvis with and without contrast revealed a large lobular mass in the left upper quadrant with unknown origin. Open exploratory laparoscopy surprisingly revealed a splenic artery aneurysm that had recently ruptured. The patient underwent distal pancreatectomy, splenectomy, and adrenalectomy during this operation. Conclusion: Although the presentation of a splenic artery aneurysm as chest pain is rare, evaluation for this pathology may be indicated in patients with new onset left chest pain, hematologic abnormalities, and negative pulmonary/cardiac workup.
Keywords
Splenic artery, aneurysm, chest pain, Ruptured Aneurysm, spleen
Disciplines
Cardiovascular System | Diagnosis | Hemic and Immune Systems | Internal Medicine | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Surgery
Document Type
Poster
Included in
Cardiovascular System Commons, Diagnosis Commons, Hemic and Immune Systems Commons, Internal Medicine Commons, Pathological Conditions, Signs and Symptoms Commons, Surgery Commons
Splenic Artery Aneurysm Masquerading as Chest Pain: A Case Report of a Rare Clinical Presentation
Background: Splenic artery aneurysms most commonly present with vague epigastric or left upper quadrant abdominal pain that may radiate to the left shoulder. Chest pain associated with splenic artery aneurysm is an unusual phenomena. This case presents a rare occurrence of a splenic artery aneurysm originally presenting as atypical chest pain. Case Presentation: A 46 year old G3P2 AAF patient with family history of hypertension presented to the ER with pleuritic left chest pain, episodes of shortness of breath, and new onset hypertension. Chest x-ray and ECG were unremarkable. Pertinent labs included a hemoglobin of 10.6 and D-dimer of 4.10. CTA of the chest revealed no evidence of pulmonary embolism. Bilateral ultrasound of the lower extremities was negative for deep vein thrombosis. Following her negative workup, the patient’s symptoms were presumed to be related to allergies or asthma, although there was no symptomatic improvement with albuterol inhaler. Following discharge, the patient’s symptoms persisted and began to present as left upper quadrant abdominal pain with fullness. CT of the abdomen and pelvis with and without contrast revealed a large lobular mass in the left upper quadrant with unknown origin. Open exploratory laparoscopy surprisingly revealed a splenic artery aneurysm that had recently ruptured. The patient underwent distal pancreatectomy, splenectomy, and adrenalectomy during this operation. Conclusion: Although the presentation of a splenic artery aneurysm as chest pain is rare, evaluation for this pathology may be indicated in patients with new onset left chest pain, hematologic abnormalities, and negative pulmonary/cardiac workup.