Splenic artery aneurysm rupture in pregnancy

Jacobson, J. N.; Gorbatkin, Chad; Good, Stacey; Sullivan, Scott

doi:10.1016/j.ajem.2016.12.035

Cited by 19 publications

(13 citation statements)

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“…Despite being an uncommon entity, SAA rupture can be catastrophic if a timely diagnosis is not achieved. For this reason, the treating physician should consider SAA rupture as a differential for any pregnant patient presenting with an acute abdomen with or without hypovolemia . If the presenting symptoms are mistaken to be those inherent to common obstetric or gynaecological emergencies, both maternal and fetal lives can be compromised.…”

Section: Resultsmentioning

confidence: 99%

“…For this reason, the treating physician should consider SAA rupture as a differential for any pregnant patient presenting with an acute abdomen with or without hypovolemia. 1,4,6,9 If the presenting symptoms are mistaken to be those inherent to common obstetric or gynaecological emergencies, both maternal and fetal lives can be compromised. Extension of the sonographic examination from the pelvis into the abdominal cavity can be advantageous in detecting haemoperitoneum associated with SAA rupture, 7 allowing appropriate treatment to ensue.…”

Section: Discussionmentioning

confidence: 99%

“…Splenic artery aneurysm (SAA) was initially documented by Beussier in 1776. It represents the third most common type of intraabdominal aneurysm following those of the aorta and iliac arteries; however, it is the most common aneurysm of the splanchnic vessels accounting for approximately 60%. The true instance of SAA is unknown due to most being asymptomatic, but rupture of this entity in pregnancy can compromise two lives.…”

Section: Introductionmentioning

confidence: 99%

“…The true instance of SAA is unknown due to most being asymptomatic, 8 but rupture of this entity in pregnancy can compromise two lives. Within the general population, a 25% mortality rate is inherent to SAA rupture 6,9,10 with the risk of death rising sharply if this occurs during pregnancy. According to the literature, a maternal mortality rate of 75% coexists with a fetal rate 6,[8][9][10][11] as high as 95%, the first mother and child to survive this phenomenon only documented 1 in 1967.…”

mentioning

confidence: 99%

“…Within the general population, a 25% mortality rate is inherent to SAA rupture 6,9,10 with the risk of death rising sharply if this occurs during pregnancy. According to the literature, a maternal mortality rate of 75% coexists with a fetal rate 6,[8][9][10][11] as high as 95%, the first mother and child to survive this phenomenon only documented 1 in 1967. Several factors innate to pregnancy, including hormonal fluctuations and hypertension, have been described to contribute to the greater incidence of this pathology in the gravid population, 8,11 with 65% of all SAA rupturing in the third trimester.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Splenic artery aneurysm rupture in the pregnant patient: The importance of utilising ultrasound to differentiate the acute abdomen from obstetric causes of abdominal pain

Napier

2019

Sonography

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Although splenic artery aneurysm (SAA) rupture in the pregnant patient is considered a rare occurrence, its consequences can be catastrophic for both mother and fetus. The mortality rate from this entity in pregnancy is disproportionately high when compared with that of the general population, with multiparity thought to be a contributing factor. Potential reasons for this may be explained by its non‐specific abdominal symptoms often misdiagnosed as common obstetric differentials, combined with a rapid deterioration of patient condition post rupture. For these reasons, SAA rupture should have a high index of suspicion when a pregnant women presents with an acute abdomen, as a favourable outcome is dependent on prompt diagnosis and appropriate medical intervention. This article reviews the incidence of SAA rupture in pregnancy, outlines the pathophysiological processes that contribute to this entity being more prevalent in the gravid population, and displays the pivotal role ultrasound can play in expediting this diagnosis. In the emergency situation, ultrasound examination of a pregnant patient should be extended from a focussed pelvic study to encompass the entire abdominal cavity. Its portability combined with its nonionising nature makes ultrasound the modality of choice to reduce the time to diagnosis and thus influence treatment pathways.

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Section: Resultsmentioning

confidence: 99%