Splenic artery aneurysm rupture in pregnancy

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.     

Rupture of an aneurysm of the ovarian artery following delivery and endovascular treatment

We report a case of spontaneous rupture of an ovarian artery aneurysm, 5 days after delivery. Severe abdominal pain justified a computed tomography scan, which revealed a massive retroperitoneal hematoma. Arteriography showed the rupture of an ovarian artery aneurysm that was successfully embolized using microcoils.     

Spontaneous rupture of ovarian artery aneurysm in the puerperium. Two case reports and a review of the literature.

A case of spontaneous puerperal rupture of an aneurysm of a branch of the right ovarian artery is reported and the histological and histochemical changes in the vessel wall are described. Identical changes were also seen in a similar case, previously reported. Some of the factors involved in the pathogenesis of these unusual vascular lesions are discussed.     

Spontaneous rupture of an ovarian-artery aneurysm in the third trimester of pregnancy

The first report of a ruptured ovarian artery aneurysm in the third trimester of pregnancy is presented. A 31-year-old woman, para 3, was admitted at 39 weeks of gestation with an acute onset of severe abdominal pain and signs of circulatory collapse. At the operation a 3 x 4 cm ruptured aneurysm of the right ovarian artery was found. The mother survived, with no sequelae. Intensive resuscitation of the infant was carried out in vain. Etiology, symptoms and differential diagnosis are discussed.     

Hypogastric artery aneurysm masquerading as an ovarian neoplasm.

Hypogastric artery aneurysm in women is rare. The case presented demonstrates how this lesion can easily mimic an ovarian neoplasm. The missed diagnosis can be catastrophic if the surgeon is unfamiliar with the retroperitoneal anatomy and is confronted with arterial hemorrhage. Hypogastric artery aneurysm should be included in the differential diagnosis of a pelvic mass in elderly women with atherosclerotic disease. The report reviews the literature on the presentation, diagnosis, and recommended treatments.     

Post partum splenic artery aneurysm rupture

Ruptured splenic artery aneurysm during pregnancy is a rare event with high maternal and fetal mortality rate. A case of ruptured splenic artery aneurysm in the post partum period is presented. The literature is reviewed on pathophysiology, clinical presentation and management of this rare and potentially fatal entity.     

Post-splenectomy splenic artery aneurysm rupture in an atypical presentation of pre-eclampsia

Splenic artery aneurysm rupture in pregnancy is an uncommon catastrophic event. We report a patient who presented at 15 3/7 weeks with atypical pre-eclampsia. After termination was recommended, the patient chose to continue the pregnancy. Reversal of clinical and laboratory abnormalities occurred and the patient was discharged. The patient presented again at 24 weeks with severe pre-eclampsia and residual splenic artery aneurysm rupture, at the site of a splenectomy that had been performed 24 years previously.     

Spontaneous rupture of splenic artery aneurysm in pregnancy. Report of first known antepartum rupture with maternal and fetal survival

The first known case of spontaneous antepartum rupture of a splenic artery aneurysm in pregnancy with maternal and fetal survival is reported. The removal of the aneurysm and splenectomy were accomplished without uterine evacuation of a 30-week gestation. A brief review of the recent literature revealed (1) the universal failure to diagnose this condition in pregnancy prior to rupture, (2) the characteristic clinical picture in pregnancy of double-rupture with a recovery phase lasting minutes to weeks, and (3) the important clinical features of abdominal hemorrhage in pregnancy from nonobstetric sources.     

Post-splenectomy splenic artery aneurysm rupture in an atypical presentation of pre-eclampsia.

Splenic artery aneurysm rupture in pregnancy is an uncommon catastrophic event. We report a patient who presented at 15 3/7 weeks with atypical pre-eclampsia. After termination was recommended, the patient chose to continue the pregnancy. Reversal of clinical and laboratory abnormalities occurred and the patient was discharged. The patient presented again at 24 weeks with severe pre-eclampsia and residual splenic artery aneurysm rupture, at the site of a splenectomy that had been performed 24 years previously.     

Review: spontaneous rupture of splenic artery aneurysm in pregnancy

Splenic artery aneurysms (SAA) occur predominantly in women and a majority of the aneurysms are asymptomatic until rupture. Over half of those that rupture occur during pregnancy or in women who have had children. Rupture during pregnancy is associated with a very high maternal and fetal mortality rate. Although this condition is uncommon, good materno-fetal outcome can only be achieved by early diagnosis and prompt treatment. It is therefore important to increase awareness of this condition so that obstetricians and other frontline staff can entertain the diagnosis of a ruptured splenic artery aneurysm in any pregnant woman who presents with severe upper abdominal pain. This article reviews the aetiology, clinical features, diagnosis and treatment of this potentially lethal condition.