Splenic artery aneurysm with double-rupture phenomenon and circulatory collapse following anesthesia induction:A case report  

作　　者：Guang-Yan Xu Ya-Hong Gong Yi Wang Xian-Lin Han Chang Hao Li Xu 

机构地区：[1]Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China [2]Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China [3]Department of Anesthesiology and Perioperative Medicine,Shenzhen Qianhai Shekou Free Trade Zone Hospital,Shenzhen 518067,Guangdong Province,China

出　　处：《World Journal of Clinical Oncology》2025年第4期291-297,共7页世界临床肿瘤学杂志(英文)

基　　金：Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-119.

摘　　要：BACKGROUND Splenic artery aneurysm(SAA)rupture is a rare,life-threatening condition characterized by acute intra-abdominal hemorrhage and hemodynamic instability.Ruptured SAAs may exhibit a biphasic and relatively slow clinical progression,commonly referred to as the“double-rupture phenomenon”.The reported incidence of the double-rupture phenomenon ranges 12%-21%in patients with ruptured SAAs,potentially due to variations in intra-abdominal pressure.Following anesthesia induction,muscle relaxation can decrease intra-abdominal pressure,potentially triggering the double-rupture phenomenon and leading to circulatory collapse.CASE SUMMARY A 61-year-old female presented to the Department of Emergency with upper abdominal pain,abdominal distension,dizziness,and vomiting.Her vital signs were initially stable.Physical examination revealed abdominal tenderness and positive-shifting dullness.Abdominal contrast-enhanced computed tomography revealed cirrhosis,severe portal hypertension,and splenomegaly.Acute rupture was suggested by a hematoma on the upper left side outside the SAA.Surgeons deemed intravascular intervention challenging and open splenectomy inevitable.Circulatory collapse occurred after anesthesia induction,likely due to a double rupture of the SAA.This double-rupture phenomenon may have resulted from an initial rupture of the SAA into the omental bursa,forming a hematoma that exerted a tamponade effect.A second rupture into the peritoneal cavity may have been triggered by decreased intra-abdominal pressure following anesthesia induction.The patient’s life was saved through early,coordinated,multidisciplinary significant postoperative bleeding or hypoxic encephalopathy.CONCLUSION Anesthesia-induced pressure reduction may trigger a second SAA rupture,causing collapse.Early diagnosis and multidisciplinary teamwork improve outcomes.This is a rare and life-threatening case of SAA rupture,which is of great significance to the medical community for understanding and handling such emergencies.

关 键 词：Splenic artery aneurysm Double-rupture phenomenon Circulatory collapse Anesthesia induction Case report 

分 类 号：P31[天文地球—固体地球物理学]