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The splenic artery aneurysm is the most common visceral aneurysm. The patient usually presents asymptomatic or with a mild left upper quadrant tenderness, sometimes it is found incidentally in an abdominal radiograph as a calcified lesion, it is confirmed by computed tomography or arteriography. The risk for rupture is high, 46% of patients will present with a massive intraperitoneal bleed requiring emergent surgical treatment. That is why we consider so important to be aware of the possibility of this diagnosis because a fast intervention will allow us to save our patient.
We are presenting a case of a 37 years old masculine patient that presents with left sided oppressive abdominal pain and low back sharp pain. Associated to nausea, soft brown fetid stools twice and two syncope episodes before admission. He is admitted with diagnosis oí probable acute pancreatitis. On the first hospitalization day the patient presented with colorless vomits, diaphoresis, pallor, tachycardia and hypotension associated to a remarkable decrease in hemoglobin level that is why he was taken to the operating room for an exploratory laparotomy. During surgery was found plenty free intrabdominal blood, splenic hiliar hematoma, necrosis on the spleen's lower pole, and splenic artery aneurism on the middle third. Splenectomy was done and a Jackson-Pratt drainage was left on the splenic region. After surgery the patient had a satisfactory recovery. The patient left the hospital on the sixth postoperative day.
