Liver cirrhosis in patients with splenic artery aneurysms frequency

İntroduction and Purpose: Splenic artery aneurysm (SAA) as an important complication of liver cirrhosis can have effect on the clinical course of the patient. The aim of our study was to determine the prevalence of SAA in liver cirrhosis and the effective factors in its development. Materials and methods: Clinical, laboratory, endoscopic and tomographic findings of the cases which were diagnosed as liver cirrhosis and had Dynamic contrast-enhanced abdominal CT (DCEA CT) were eveluated retrospectively. In the radiologic assesment, the presence of hepatocellular carcinoma, ascites, portal vein trombosis were investigated along with presence of SAA, its localisation, count and diameter of aneurysm. Diameters of portal and hepatic veins and hepatic artery were measured. Findings: 171 patients, 109 male (63.7%) and 62 female (36.3%), were assessed in total. Etiology of cirrhosis in these patients were chronic hepatitis B (HBV) (34.5%), HBV+ chronic hepatitis delta (HDV) (25.14%), cryptogenic (22.2%), chronic hepatitis C infection (HCV) (11.6%), Budd-Chiari syndrome (2.9%) and rare diseases, respectively. 37.4% of cases was Child A, 38% of cases were Child B, 24.5% cases were Child C patients. SAA was detected in 27 (15.7) patients. The average diameter of the aneurysm was 11.66 mm (between 6.06-27.1 mm). In 20 patients (74%), aneurysm was located in hilus of spleen; in 4 cases (11.2%), it was in the middle; in 2 patients, it was in proximal; and in one patient, there was aneurysm both in hilus and in the middle region. Aneurysm was one in 24 (88.8%) cases and more than one in 3 (11.2%) patients. The group of patient with SAA was younger (49±13.36 year vs. 56±13.77 year, p=0.031) and aneurysm was detected more frequent in women than in men (%23.2 vs %12, p=0.05). In the group of patients with SAA, a lower percentage of chronic HCV infection (%0 vs %14.6, p=0.008) and a lower percentage of chronic HDV infection (%22.2 vs. %46.4, p=0.005) were detected. Besides, in the group of patients with SAA, lower levels of AST(75±85 vs 93±192, p=0.034) and platelet (78000±47100/mm3 vs 115.8±98.2, p=0.017) were detected. Although diameters of portal vein and splenic vein (15,4±3,8 mm vs 13.1±2.9 mm, p=0.001; 12.6±4.3 mm vs 9.6±2.7 mm, p= <0.001, respectively) were significantly wider in group with SAA, diameter of hepatic artery was significantly more narrow (3.7±1.2 mm vs. 4.5±1.2 mm, p=0.005). In multivariate analysis, although an inverse relationship between development of SAA and diameter of hepatic artery (OR=0.48, %95 CI=0.27-0.85; p=0.011), and a direct relationship between SAA and diameter of splenic vein were detected, a relationship between other parameters and occurrence of aneurysm was not detected. In conclusion, SAA can develop in a significant part of cirrhosis cases. The existence of SAA and accordingly considering complications that could occur due to it can be useful during the monitoring of cirrhosis patients,. Results: SAA can occur in important proportion of cirrhosis cases. During the monitoring of cirrhosis patients, considering existence of SAA and complications that could occur due to SAA can be useful.