title: Spontaneous rupture of the spleen: a rare but serious case of acute abdominal pain in pregnancy.
abstract: BACKGROUND
  Spontaneous (non-traumatic) rupture of the spleen rarely occurs in the setting of a normal spleen, especially during pregnancy.
  
  
  OBJECTIVE
  We report a case of spontaneous rupture of a normal spleen at 33.7 weeks gestation and review the literature with the aim of exploring the etiology, diagnosis, and management of this condition during pregnancy.
  
  
  METHODS
  A 30-year-old Chinese primigravida presented at 33.7 weeks gestation with acute onset of severe, constant left upper abdominal pain. She developed acute hypotension. Physical examination revealed diffuse abdominal tenderness with rebounding and guarding. An emergent cesarean delivery and abdominal exploration was performed. A non-viable male infant was delivered, and active bleeding was identified at the splenic hilum consistent with splenic rupture. A splenectomy was performed, and a consumptive coagulopathy was identified and treated. The patient had an uncomplicated postoperative course and was discharged home on postoperative day 15.
  
  
  CONCLUSIONS
  Splenic rupture in pregnancy is a life-threatening complication. Early diagnosis and aggressive surgical intervention will allow for optimal maternal and perinatal outcome.
authors.affiliation: Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China.
authors.forename: Chenhong
authors.initials: C
authors.lastname: Wang
authors.forename: Xinzhi
authors.initials: X
authors.lastname: Tu
authors.forename: Shengli
authors.initials: S
authors.lastname: Li
authors.forename: Guoyang
authors.initials: G
authors.lastname: Luo
authors.forename: Errol R
authors.initials: ER
authors.lastname: Norwitz
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis*; D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012422:Rupture, Spontaneous / Q000175:diagnosis; D012771:Shock, Hemorrhagic / Q000209:etiology; D013161:Splenic Rupture / Q000175:diagnosis*; D050497:Stillbirth