Post Partum Splenic Artery Aneurysm Rupture

Asokan, S. A.; Chew, E. K.; Ng, Kartashevskiĭ; Thanaletchimy, N; Asmiati, A.; Kong, N. M.

doi:10.1111/j.1447-0756.2000.tb01311.x

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Left shoulder pain, which the patient noticed initially, is likely to reflect premonitory bleeding of the aneurysm. According to Connery et al, the pathology of internal thoracic artery aneurysms included intimal dissociation and degeneration of the arterial wall (1), (6). Unfortunately, no arterial specimen was available to verify these pathology; however, the present case illustrates aneurysmal rupture as a cause of acutely developed circulatory collapse during perinatal period.…”

Section: Discussionmentioning

confidence: 74%

“…There is no evidence which links the development of aneurysm and pregnancy in this patient; however, pregnancy was reportedly associated with development of aneurysms (1), presumably due to increased blood volume, endocrinal changes, and increased blood pressure (2), (3). There are in fact several reports on life‐threatening aneurysmal rupture associated with pregnancy (1), (6), (7). In this sense, it is possible that aneurysmal rupture in the present case is associated with pregnancy and delivery.…”

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

Massive hemothorax due to rupture of internal thoracic artery aneurysm after vaginal delivery

Morimatsu

Koga

Akiyoshi

et al. 2007

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 89%

Massive hemothorax due to rupture of internal thoracic artery aneurysm after vaginal delivery

Morimatsu

Koga

Akiyoshi

et al. 2007

Acta Obstet Gynecol Scand

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“…An initial review of the literature suggests that the maternal mortality rate is 72% and foetal mortality of 97% [6]. There is a reported case of post-partum splenic artery aneurysm rupture [7]. Rupture tends to occur in the final trimester of pregnancy and prolonged hypertension may be a contributory factor.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous ruptured splenic artery aneurysm: a case report

Betal

Khangura

Swan

et al. 2009

Cases J

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“…It tends to occur in older women (average age 30) and more frequently during the third trimester. It is interesting to note that only two cases of postpartum splenic aneurysm rupture has been reported so far in the literature (4, 5). Postpartum rupture of splanchnic aneurysms may be precipitated by sudden rise in cardiac output after delivery.…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of hypovolemic shock in the postpartum period

Pandian

Wagaarachchi

Danelian

2001

Acta Obstet Gynecol Scand

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Aneurysm of the splenic artery is the second most common intra-abdominal aneurysm affecting women four times as frequently as men, principally during child bearing ages. Certain physiological changes in pregnancy: hemodynamic stresses, matrix and elastic tissue changes in arterial walls, predispose pregnant women with aneurysms at high risk of rupture. It needs to be emphasized that in developed countries ruptured splenic artery aneurysm is becoming an important cause of maternal morbidity and mortality. Case reportA 31-year old woman had an uncomplicated pregnancy and a spontaneous vaginal delivery at term. Her obstetric history was of one lower segment cesarean section followed by two spontaneous vaginal deliveries and there was nothing of note in her past medical history.She started to feel unwell and complained of left shoulder tip pain, 16 hours post partum. She was well on examination and with a hemoglobin of 11g/dl. Simple oral analgesia and antacids were administered. Eleven hours later she complained of severe left shoulder tip and left upper quadrant pain, with tiredness and shortness of breath. She was hemodynamically stable and oxygen saturation and blood gases were normal. Hemoglobin was 9.2 g/dl, clotting screen and ECG were normal and there were no significant findings on clinical examination. Pulmonary embolism was initially suspected. She was intensively monitored in the recovery unit. Her condition deteriorated over the next three hours. The blood pressure dropped to 50/30 and the pulse was over 120 beats per minute. She remained conscious and responsive to stimuli. The abdomen was distended and tender but soft. Bleeding per vaginum was minimal. Bimanual pelvic examination revealed mild tenderness over the uterus and in both fornices, the uterus was not deviated and there was no evidence of uterine scar rupture. Her blood pressure responded to intravenous colloids. Chest x-ray, ECG, blood gases and oxygen saturation continued to remain normal but the hemoglobin was now 6.9g/dl. A major intraperitoneal hemorrhage was diagnosed. Rupture of the uterine scar and broad ligament hematoma were considered, but clinical examination did not support these diagnoses. Blood transfusion was commenced and an C Acta Obstet Gynecol Scand 80 (2001) emergency laparotomy performed through a midline incision, which confirmed a large intraperitoneal hemorrhage of 3.5 litres.The uterus was intact and a diagnosis of a ruptured splenic artery aneurysm was established. The critical care team and vascular surgeons were involved and splenectomy was carried out. The patient required infusion of 27 units of packed cells in total along with fresh frozen plasma, cryoprecipitate and platelets. She made a good post-operative recovery after being cared for in the intensive therapy unit. Post operatively she was commenced on aspirin 300 mg/day in view of persistent thrombocytosis and was discharged home on the 13th post operative day with long-term penicillin V 500mg a day and Meningovax, Pneumovax and Hemophilus B vaccinations. S...

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Post Partum Splenic Artery Aneurysm Rupture

Cited by 10 publications

References 5 publications

Massive hemothorax due to rupture of internal thoracic artery aneurysm after vaginal delivery

Massive hemothorax due to rupture of internal thoracic artery aneurysm after vaginal delivery

Spontaneous ruptured splenic artery aneurysm: a case report

An unusual cause of hypovolemic shock in the postpartum period

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