Basic Data Underlying Clinical Decision Making

Aneurysms involving the splanchnic arteries represent an uncommon and potentially lethal form of vascular disease. Because they frequently present as life-threatening clinical emergencies, a clear understanding of the presentation and management of these aneurysms is essential for the practicing vascular surgeon. The purpose of this review was to document recent changes in the diagnosis and management of common splanchnic artery aneurysms. Traditionally the most commonly reported splanchnic artery aneurysms have involved, in decreasing order of frequency, the splenic, hepatic, and celiac arteries.~ We reviewed the English language literature for the past 10 years (1985 to 1995) for reports of these lesions. Interestingly, in contrast to previously published series, aneurysms of the hepatic arteries were the most frequently reported splanchnic artery aneurysms in the past decade. This trend probably relates to the increasing use of percutaneous diagnostic and therapeutic biliary tract procedures. During these procedures, injury to the intrahepatic branches of the hepatic artery can lead to the development of false aneurysms of these vessels. In addition to these iatrogenic false aneurysms, the increased use of diagnostic CT scanning following blunt liver trauma has also led to increased detection of posttraumatic false aneurysms of the intrahepatic arterial