The lumbar spine x-ray shows an incidental finding of a calcified splenic artery aneurysm as evidenced by a rounder calcific area in the left upper quadrant.

The finding was confirmed on a subsequent CT scan. The patient opted for no treatment in view of multiple comorbidities.

• Splenic artery aneurysms are the 3rd most common intra abdominal aneurysms after aortic and iliac artery aneurysms. Catastrophic complication is rupture.
• Risk factors are female gender, multiple pregnancies and portal hypertension.
• Early elective repair is recommended for splenic artery aneurysm in pregnant women and women of child bearing age. Patients with portal hypertension and those who are about to undergo liver transplantation are also candidates for treatment. Enlarging aneurysms or aneurysms more than 2.5-3cm in diameter will need specialist referral (vascular or interventional services).

Reference: https://pubs.rsna.org/doi/full/10.1148/rg.266055732