title: Laparoscopic aneurysm resection and splenectomy for splenic artery aneurysm in the third trimester of pregnancy.
abstract: BACKGROUND
  Splenic artery aneurysms (SAA) are a rare entity most commonly diagnosed incidentally. Their association with pregnancy increases the risk of rupture resulting in a disproportionately high maternal and fetal mortality. Accordingly, elective surgical treatment is recommended in asymptomatic patients with aneurysms less than 2 cm. In this case, we present a patient during her third trimester of pregnancy with a SAA who was treated by laparoscopic aneurysm resection and splenectomy.
  
  
  METHODS
  The patient is a 38-year-old multiparous woman, with an incidental diagnosis of a SAA in 2010. Subsequently, the patient became pregnant and at 27 weeks started to develop abdominal pain. Failed embolization was attempted with worsening of the patient's symptoms. A CT angiogram revealed a 1.6 cm distal third SAA without any evidence of rupture. Due to the localization of the lesion, the patient was offered a laparoscopic aneurysm resection and splenectomy.
  
  
  RESULTS
  Operating time was 90 min and estimated blood loss was 5 cc. Postoperative fetal monitoring was normal. No perioperative complications were observed. The patient was discharged on postoperative day 3. Two months after laparoscopic splenectomy, the patient delivered a male infant in perfect health.
  
  
  CONCLUSIONS
  Although this is a rare disease, the risk of aneurysmal rupture is increased during pregnancy. As a result of high maternal and fetal mortality, elective surgery should be performed. Laparoscopic surgery is the technique of choice.
authors: Section of Minimally Invasive and Robotic Surgery, Department of Surgery, College of Medicine, University of Arizona, 1501 N. Campbell Avenue, P.O. Box 245066, Tucson, AZ 85724-5066, USA.
authors: Julia
authors: J
authors: Samamé
authors: Amit
authors: A
authors: Kaul
authors: Ulises
authors: U
authors: Garza
authors: Angela
authors: A
authors: Echeverria
authors: Carlos
authors: C
authors: Galvani
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000601:surgery*; D011263:Pregnancy Trimester, Third; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods*
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