Rupture of the spleen or splenic vessels (splenic emergency syndrome) in late pregnancy: A report of two autopsy cases

Gebeliğin üçüncü üç aylık döneminde kendiliğinde gelişen dalak rüptürü: vaka sunumu

“…The factors increasing the intra-abdominal pressure such as coughing and vomiting may be responsible for the etiology of splenic rupture in pregnancy. In addition, the hemodynamic changes like increased circulating blood volume and increased circulating hormones such as estrogen and progesterone may cause structural changes to the spleen and may increase the risk of splenic rupture during pregnancy [6]. The major problem associated with splenic rupture in pregnancy is late or misdiagnosis.…”

Rupture of a Splenic Artery Aneurysm in the First Trimester of Pregnancy

“…There is an increased risk associated with multiparity and in the third trimester of pregnancy (5,(7)(8)(9). The rupture rate during pregnancy seems to be around 12% in the first two trimesters, 69% in the third, 13% during labor, and 6% in the postpartum period (10).…”

“…At the same time, hormones may explain the histologic remodeling found in this type of aneurysm, where atherosclerosis is very rare. Estrogens, progesterone, and relaxin may influence arterial wall remodeling and induce fibromuscular dysplasia of the tunica media and fragmentation of the elastic fibers, thereby promoting development of the aneurysm (1,4,9). Pathological examinations of aneurysms often find such dysplasia, but other abnormalities are also observed, including intramural hemorrhages and chronic inflammatory or infectious phenomena responsible for the arterial damage (9).…”

Spontaneous Rupture of the Spleen: A Rare but Serious Case of Acute Abdominal Pain in Pregnancy

“…Spontaneous rupture of a normal spleen without a history of trauma is an extremely rare clinical event. A total of 20 cases have been reported (Table 1) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The first case of splenic rupture in pregnancy was reported by Saxtroph in 1803 (12).…”

“…In addition, the hemodynamic changes that accompany pregnancy may predispose to spontaneous splenic rupture via two possible mechanisms. First, the combined effects of the increased circulating blood volume and reduced volume of the peritoneal cavity due to expansion of the gravid uterus may make the spleen more fragile and therefore more vulnerable to rupture (5). In keeping with this hypothesis, it is interesting that most reported cases have occurred in multiple pregnancies or in the third trimester of pregnancy.…”