Aneurismi splancnici e dell'arteria renale

The aneurysmal disease, although more rarely, can also affect arterial districts other than those traditionally involved the evolution aneurysm. After the vessels of large caliber also the visceral arteries originating from abdominal aorta may be the site of aneurysmal dilatation or pseudoaneurysm. The involvement of the renal and splanchnic vessels, although rare with an incidence from 0.1 to 2%, it can also cause catastrophic outcomes. The data reported in the literature are the case reports with limited evidence-based medicine. Autopsy studies suggest that there may be more frequent than in aortic: 10% versus 0.5%. The prevalence is 2% of the population. The age at which most frequently occurs detection of a visceral aneurysm, varies between 60 and 70 years. The vessels involved are those that emerge from abdominal aorta and go respectively to spray the kidneys (renal artery), spleen (splenic artery), liver (hepatic artery), stomach, duodenum, pancreas and intestine (celiac superior mesenteric artery, pancreatic-duodenal artery, gastroduodenal artery and gastro-epiploic arteries jejunal and ileo-colic, inferior mesenteric artery and its branches). As can be seen from the data in the literature, the incidence of aneurysms is as follows: renal artery aneurysm: 1-3%, splenic artery aneurysms: 60%; Hepatic artery: 16-20%; the superior mesenteric artery: 5.5%; of the celiac trunk: 4%; pancreatic-duodenal artery: 3%; gastroduodenal artery and gastroepiploic: 4%; of the jejunum and ileum-colic arteries: 3%; inferior mesenteric artery and its branches: 3.5%. In a third of cases of aneurysm of the splenic artery is an association between multiple arterial districts, appearing in multiple form. The evolution of the aneurysm is similar to that of the artery aneurysms of medium and large caliber and is characterized by progressive expansion and by the formation of thrombi, contributing to the three major complications: rupture, events thrombo-embolic ischemic, and compression or erosion of the neighboring structures. The rupture is the most frequent and letal complication.