Skip to Main Content


Visceral artery aneurysms (VAAs) include aneurysms affecting the celiac, superior mesenteric, and inferior mesenteric arteries and their branches. VAAs are rare with a reported incidence of 0.01% to 2% based on autopsy results, but the incidence has been reported as high as 10% in the elderly population.1,2 They comprise only 5% of aneurysms within the abdominal cavity. Of those who present with a VAA, 45% have aneurysms in other locations, such as the aorta, iliac renal, lower extremity, intracranial, and other visceral vessels.3

VAA was first reported by Beaussier in 1770, who described a splenic artery aneurysm found on autopsy of a 60-year-old woman.4 The first hepatic artery aneurysm (HAA) was described in 1809 by Wilson after a postmortem examination demonstrated a ruptured left HAA. In 1903, Kehr described the first repair of a VAA by ligating a proper HAA.5 De Bakey reported the repair of a mycotic superior mesenteric artery aneurysm (SMAA) in 1953.6

VAAs include both true and false aneurysms. Atherosclerosis is the most common cause of true visceral aneurysms, although they can be associated with medial degeneration, connective tissue diseases, such as Ehlers–Danlos syndrome and Marfan syndrome, fibromuscular dysplasia, pregnancy, portal hypertension, and posttransplant status. Visceral pseudoaneurysms are a result of trauma, infection, inflammation, and iatrogenic causes. VAAs are also associated with some rare conditions, such as Von Recklinghausen disease, polyarteritis nodosa, and Behcet disease.1,7,8

Most visceral aneurysms are found in the splenic artery (40%–60%). This is followed by the hepatic artery (19%–25%), the superior mesenteric artery (SMA, 4%–9%), and the celiac trunk (3%–4%). Aneurysms of the gastroduodenal and pancreaticoduodenal arteries along with other visceral branches are even rarer (Table 28-1).1,2,9,10

TABLE 28-1Distribution of Visceral Artery Aneurysms

Splenic Artery Aneurysms

Splenic artery aneurysms (SAAs) are the most common type of VAA accounting for 60% of all visceral aneurysms.1 Autopsy studies have shown an incidence of 0.01% to 0.23% in the general population, with the incidence rising as high as 10.4% in autopsies performed when specific attention was paid to evaluate the splenic artery for aneurysms as they can often be missed in their nonruptured, relatively small states on routine autopsy.11 Most SAAs are located in the distal third of the artery and are saccular in morphology. Women are more affected than men by a ratio 4 to 1. Underlying etiologies include atherosclerosis, arterial fibrodysplasia, and arteritis. Additionally, female gender, multiparty, and portal hypertension are associated risks. In a 20-year review of 100 cases of splenic artery aneurysms, ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.