Splenic Arterial Aneurysm

Berger, James S.; Forsee, James H.; Furst, John N.

doi:10.1097/00000658-195301000-00018

Cited by 34 publications

(8 citation statements)

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“…Berger et al [35] and Greene et al [36] recommend aortography as a reliable diagnostic method in patients with a latent period between episodes of bleeding who are suspected of harboring an aneurysm of the splenic artery, such as the case described by Gillam [37].…”

Section: Discussionmentioning

confidence: 99%

“…Our third patient also demonstrated double rupture. Her first rupture occurred shortly after delivery, followed by recovery and then 3 hours later collapse.Berger et al [35] and Greene et al [36] recommend aortography as a reliable diagnostic method in patients with a latent period between episodes of bleeding who are suspected of harboring an aneurysm of the splenic artery, such as the case described by Gillam [37].The difficulty in making a correct diagnosis prior to laparotomy is understandable because of the many obstetrical complications that simulate rupture of a splenic aneurysm, most of them more frequently encountered conditions. In early pregnancy, it resembles a ruptured ectopic pregnancy and in advanced pregnancy mimics ruptured uterus, abruptio placentae, intraabdominal trauma, complication of ovarian cyst, bleeding from ectopic decidua, gastrointestinal hemorrhage, and bleeding from a hepatoma.…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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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“…Berger, Forsee, and Furst (1953) considered their case to be the eleventh diagnosed before operation in the English literature.…”

Section: Discussionmentioning

confidence: 99%

“…Complete calcification can be demonstrated only by detailed anatomical study. Berger et al (1953), from a study of the literature, state that 35%/o of splenic arterial aneurysms rupture. It is difficult to assess the number of aneurysms at risk, and also the number that rupture, but this figure seems far too high.…”

Section: Treatmentmentioning

confidence: 99%