Spontaneous rupture of splenic artery aneurysm in pregnancy: A case report and review of the literature

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Abstract
Introduction: Splenic artery aneurysms (SAAs) are the most common (60%) of visceral artery aneurysms with the possibility of rupture. SAA rupture is associated with 20% mortality, which increases disproportionately to 75% in pregnant women, with fetal the mortality rate of 95%. Aim: We present a discussion based on the case report with a review of the literature on ruptured SAA in pregnancy as well as possible treatment options, complications and prognosis. Case study: Patient, 40-year-old pregnant woman, gravida 2, para 1, 33 week of pregnancy, with ruptured SAA, underwent cesarean section, splenectomy, and hypovolemic shock treatment. The outcomes of the mother and neonates were good. Postoperative recovery was complicated by right-sided pneumothorax. Results and discussion: 87% of patients with SAA are females. In our analysis of cases, with ruptured SAA in pregnancy, the parity may be the factor that influences the maternal and fetal outcomes. In third trimester of pregnancy (as in our case study) the most often mistaken indication for laparotomy was a suspected placental abruption. Conclusions: Ruptured SAA during pregnancy should be considered as one of the non-obstetric causes of intraabdominal bleeding. Careful observation of the patient from the onset of symptoms is a key approach that increases maternal and fetal survival.

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