title: Ruptured splenic artery aneurysm in pregnancy. Twelfth reported case with maternal and fetal survival.
abstract: Ruptured splenic artery aneurysm during pregnancy is a rare event with catastrophic consequences. This presentation is the twelfth case during pregnancy reporting survival of both mother and fetus. The literature reports a 25% mortality rate for ruptured splenic artery aneurysm. The mortality rate among pregnant women is disproportionately high at 75% with a fetal mortality rate of 95%. Gestational alterations that increase with parity are significant in the pathophysiologic characteristics of this condition. A unique double-rupture phenomenon may provide temporary tamponade with resolution of symptoms. A diagnosis of ruptured splenic artery aneurysm should be considered in any pregnant patient who complains of the sudden onset of severe left upper-abdominal pain regardless of whether pain or shock is prominent at the time of evaluation. Early consideration of a diagnosis of ruptured splenic artery aneurysm significantly increases the likelihood that the mother and fetus will survive.
authors.affiliation: Huntington Memorial Hospital, Pasadena, CA.
authors.forename: J C
authors.initials: JC
authors.lastname: Caillouette
authors.forename: E B
authors.initials: EB
authors.lastname: Merchant
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000401:mortality / Q000601:surgery*; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D006801:Humans; D008428:Maternal Mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012422:Rupture, Spontaneous; D013157:Splenic Artery; D016019:Survival Analysis