The incidence of splenic hemangioma and its rupture risk
Ersin Gundogan1, Mufit Sansal1, Orgun Gunes1, Eray Can Akinci2, Tarik Emre Erkenekli2, Fatih Sumer1,
Ramazan Kutlu3, Cuneyt Kayaalp1
1Inonu University, Faculty of Medicine, Department of General Surgery, Malatya, Turkey
2Inonu University, Faculty of Medicine, Department of Medical Student, Malatya, Turkey
2Inonu University, Faculty of Medicine, Department of Radiology, Malatya, Turkey
Aim: The incidence of splenic hemangioma was reported in a wide range (0.03-14%) based on the autopsy data between the years of 1895-1965. The suggested treatment in an early systematic review was routine splenectomy due to the fear of splenic rupture. We aimed to determine the incidence of splenic hemangiomas in the modern imaging era, to evaluate the rupture risk and the necessity of splenectomy for every splenic hemangioma.
Material Method: Between January and December 2016, the reports of all patients who had any abdominal imaging modalities in our hospital were electronically scanned for splenic hemangiomas. Repeated examinations were excluded. Age, gender, reason of radiological examination, imaging modality, number and the size of the splenic hemangiomas, hematological test and the follow-up results were evaluated.
Results: Total 31 of 30,021 (0.1%) patients with abdominal imaging examinations were diagnosed as splenic hemangioma. Fifty-eight percent were female and the mean age was 50.1±15.4 (median and range, 52 and 12-75). Only two referred with abdominal pain but the pain localizations were incompatible with hemangiomas. Mean hemoglobin values were found to be 13.2±2.2 gr/dl and platelet counts were found to be 249.300±115.800. The dimensions of the detected lesions were mean 13.1± 8.1 (median 1, range 0.5-4.5 cm) and only one patient had multiple involvement. Splenic rupture was detected in a patient with chronic renal failure and splenectomy was performed.
Conclusion: Routine splenectomy for <4.5 cm splenic hemangiomas is not essential but longer follow-up is required. More studies for 4.5 cm< splenic hemangiomas are necessary.