Minimally Invasive Management of a Hilar Splenic Artery Aneurysm: A Case Report.

Splenic artery aneurysm (SAA) is a rare vascular condition associated with a high risk of rupture, particularly in women of reproductive age. We report the case of a 28-year-old woman with a history of cesarean section and laparoscopic cholecystectomy who presented with persistent, nonspecific abdominal discomfort. Imaging revealed a 2 cm saccular, true aneurysm at the splenic hilum. Following multidisciplinary discussion, endovascular treatment was not considered feasible due to the aneurysm's hilar location and the associated risk of splenic infarction. Surgical treatment was therefore planned, and a laparoscopic splenectomy was chosen. The procedure was performed using two 10 mm and one 5 mm trocars. Dense hilar fibrosis was encountered intraoperatively; vascular control was carefully established before dissection to reduce the risk of bleeding. The spleen was removed via the previous Pfannenstiel incision without complications. The patient recovered uneventfully and was discharged on postoperative day 3. Histopathological examination confirmed a true, unruptured aneurysm. This case highlights that laparoscopic splenectomy can be a safe and effective treatment option for selected patients with hilar SAA. Although the vascular nature of these lesions may raise concerns regarding intraoperative bleeding, a minimally invasive approach may be feasible when performed by surgeons with sufficient laparoscopic experience in appropriately selected cases.