Korean J Obstet Gynecol.  2002 Jun;45(6):1064-1068.

A Case of Spontaneous Rupture of a Splenic Artery Aneurysm in the Third Trimester

• Lee HE
• Joung BH
• No JY
• Joo IS
• Shim JS
• Seo KY

Abstract

The spontaneous rupture of splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two thirds of all ruptures happen during the third trimester. Clinical presentation is often non-specific, with good hemodynamic compensation, followed by a rapid deterioration. Active management and operation are the most important procedures for diagnosis and therapy of the bleeding. Abdominal delivery will help to establish diagnosis and should be performed immediately. We report a case of a patient at 38 weeks of gestation suffering epigastric pain and fetal distress. At emergency cesarean delivery, an aneurysmal rupture of the splenic artery was found to be the reason for the hemoperitoneum. Spleen, aneurysm and the tail of the pancreas were removed. In spite of fatal hemorrhage, the patient survived but her fetus was dead. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.

Keyword

Ruptured splenic artery aneurysm; Pregnancy

MeSH Terms

Aneurysm*
Cesarean Section
Compensation and Redress
Diagnosis
Emergencies
Female
Fetal Distress
Fetus
Hemodynamics
Hemoperitoneum
Hemorrhage
Humans
Pancreas
Pregnancy
Pregnancy Trimester, Third*
Rupture
Rupture, Spontaneous*
Spleen
Splenic Artery*