title: Splenic artery aneurysm rupture in pregnancy.
abstract: 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.
authors: Department of General Surgery, University of Western Australia, St John of God Hospital (Subiaco), Subiaco, WA 6003, Australia. jenha81@yahoo.com.au
authors: Jennifer Fong
authors: JF
authors: Ha
authors: Michael
authors: M
authors: Phillips
authors: Kingsley
authors: K
authors: Faulkner
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012422:Rupture, Spontaneous; D013156:Splenectomy; D013157:Splenic Artery