Abstract
INTRODUCTION: Splenic artery aneurysm (SAA) is a rare but potentially life-threatening condition. SAA can occur following an acute or chronic pancreatitis as a pseudoaneurysm, iatrogenic (post-pancreatic/splenic surgery) or post-traumatic. If symptomatic, it needs to be treated urgently as it has a high risk of rupture. CASE PRESENTATION: Here is a case where a ruptured aneurysm presented in an unusual manner: first as an acute abdomen and second, delayed, as hemorrhagic shock. Only emergency laparotomy and splenectomy saved the patient's life. CONCLUSION: If a splenic artery pseudoaneurysm is detected on CT scan, there is an increased risk of rupture irrespective of the size and the patient that should be proactively managed. Concomitant abdominal findings and diseases can delay diagnosis and underestimate the risk.