Laparoscopic treatment for a rare case of giant spleen with splenic arteriovenous fistula and giant vein aneurysm: multidisciplinary management and case report

腹腔镜治疗罕见巨脾伴脾动静脉瘘和巨大静脉瘤:多学科诊疗及病例报告

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Abstract

Splenic arteriovenous fistula (SAVF) is a rare vascular condition characterized by an abnormal connection between the splenic artery and vein, often leading to complications such as portal hypertension. While uncommon, SAVFs can arise from trauma, inflammatory diseases, or idiopathically. They frequently coexist with splenic artery aneurysms, complicating diagnosis and management. Advances in imaging, particularly computed tomography angiography, have significantly improved detection, enabling earlier intervention. If left untreated, SAVFs can result in severe complications, including gastrointestinal bleeding and non-cirrhotic portal hypertension. Early recognition is crucial for preventing life-threatening outcomes and optimizing treatment. The laparoscopic approach has gained attention as a less invasive alternative. However, laparoscopic management presents significant technical challenges due to the complex vascular anatomy, risk of excessive bleeding, and difficulty in accessing the splenic hilum.

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