Rupture of a splenic arterial aneurysm as a fatal complication of pregnancy

Ja, Chalmers

doi:10.1002/bjs.18003714515

Cited by 13 publications

(4 citation statements)

References 21 publications

(7 reference statements)

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“…The features of this condition are well described elsewhere (Sherlock and Learmonth, 1942;Chalmers, 1949;Owens and Coffey, 1953;and others), and mention is herc made only of the salient points.…”

Section: Discussionmentioning

confidence: 84%

Splenic Arterial Aneurysm

Ward‐McQuaid¹

1958

BMJ

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Section: Discussionmentioning

confidence: 84%

Splenic Arterial Aneurysm

Ward‐McQuaid¹

1958

BMJ

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“…The lesions are generally regarded as congenital, with the atherosclerotic changes superimposed on the congenital defect [9,10,[26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…Most were diagnosed as intraabdominal hemorrhage of unknown origin. A lesion of the spleen was suspected in 12 cases but a ruptured splenic aneurysm was diagnosed preoperatively in only three [22,27,31]. Nine of the 12 mothers survived and this emphasizes the importance of the primary recognition of such a rare occurrence.…”

Section: Discussionmentioning

confidence: 99%

Rupture of Splenic Artery Aneurysm During Pregnancy: Three Case Reports with a Review of the Literature

Algwiser

1991

Ann Saudi Med

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AA Algwiser, Rupture of Splenic Artery Aneurysm during Pregnancy: Three Case Reports with a Review of the Literature. 1991; 11(2): 221-225 Aneurysms of the splenic artery are rare. They remain silent until rupture. Because of their frequent association with pregnancy, this is a topic of special interest to obstetricians, particularly because of the difficulty in diagnosis and because it carries a very high maternal and fetal mortality. We report three cases of ruptured splenic artery aneurysm occurring in the third trimester of pregnancy and puerperium, bringing the total number of cases reported in the literature to 75. Case Reports Patient 1A 32-year-old Saudi woman (para 5, gravida 8) was admitted on 12 October 1987 at 2240 hours. Since 1300 hours she had had shortness of breath, nausea, epigastric and shoulder pain, and abdominal pain, especially over the right iliac fossa. On admission, her temperature was 37°C; pulse, 84 per minute; and blood pressure, 115/70 mm Hg. Fundal height corresponded to 38 weeks' gestation with a cephalic presentation. Fetal heart sounds were audible. The abdomen was soft, and cardiotocography showed a reactive tracing with mild uterine contractions. Vaginal examination revealed a parous cervical os, uneffaced cervix, and a high presenting part. Pulse was 80 per minute; blood pressure, 110/70 mm Hg; there was proteinuria+ but the abdomen was soft. There were no uterine contractions and no bleeding per vaginam. An intravenous line was started and the patient was given 10 mg of metoclopramide hydrochloride intramuscularly and discharged home. At 0815 hours, her condition deteriorated and she was readmitted. She was pale and hyperventilating, and her pulse had risen to 140 per minute with blood pressure dropping to 100/80 mm Hg. Her abdomen became tense and painful, and fetal parts were impossible to palpate. An urgent ultrasound was carried out which was suggestive of abruptio placentae. The patient was rushed to the obstetric theatre for emergency cesarean section. The abdomen was entered through a subumbilical midline incision and about 1,500 ml of blood was encountered in the peritoneal cavity. No bleeding source could be found.A male infant, weighing 2,760 gm with an Apgar score of 5 at 1 minute and 5 at 5 minutes, was delivered by lower-segment cesarean section. After closure of the uterus, there was no evidence of further hemorrhage in the abdominal cavity, so the abdomen was closed. While the patient was still in the recovery room, her condition deteriorated. Her pulse rose, she became pale, and the abdomen became distended. Her hemoglobin dropped to 36 gm/L. In view of this, the abdomen was re-entered through the previous incision, which was extended upward to the left costal margin. Three liters of blood clot were found in the peritoneum. At first the bleeding was thought to originate from the liver or stomach, as the uterus was intact and well contracted, but after blood was evacuated from the abdominal cavity, it was obvious that the source of bleeding was from a ruptu...

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“…There appears to be an undoubted cause-andeffect relationship between rupture of aneurysm of the splenic artery and late pregnancy, a relationship reviewed in several papers and lately summarized by Chalmers (1949). Altogether 31 cases have been recorded of aneurysm of the splenic artery associated with pregnancy.…”

Section: Age Incidencementioning

confidence: 99%