Splenic artery aneurysm rupture in pregnancy
Fong Ha, J., Phillips, M., & Faulkner, K. (2009). Splenic artery aneurysm rupture in pregnancy. European Journal of Obstetrics, Gynecology and Reproductive Biology, 146(2), 133-137. doi:10.1016/j.ejogrb.2009.05.034
Splenic artery aneurysm (SAA) is the commonest visceral artery aneurysm. It is diagnosed more frequently in younger women, with up to 95% presenting during pregnancy. Rupture is associated with a disproportionately high maternal and fetal mortality.
We performed a literature search on the patient and SAA characteristics, clinical presentations, management and outcome of this serious complication.
There were 32 patients in total with a mean age of 27.9 years (range 20–38). The mean SAA size was 2.25 cm (range 0.5–4 cm) and from the available data half of the ruptured SAA were 2 cm or less. Only one case (3.1%) was discovered incidentally, whilst the rest (96.9%) were found following rupture. The majority ruptured spontaneously. Most (62%) of the patients underwent SAA ligation and splenectomy. The maternal death rate was 21.9% (n = 7), and fetal death rate was 15.6% (n = 5).
Most cases are not diagnosed until surgery following rupture. Ruptured SAA should be considered in the differential diagnosis of a pregnant patient with severe and unexplained abdominal pain.
peer-reviewed, splenic artery aneurysm, rupture, pregnancy, survival, management, subsequent pregnancy