Splenic artery aneurysms during pregnancy: An obstetric nightmare

Wiener, Yifat; Tomashev, Roni; Neeman, Ortal; Itzhakov, Zalman; Heldenberg, Eitan; Melcer, Yaakov; Maymon, Ron

doi:10.1016/j.ejogrb.2019.04.029

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…As long as definitive predictors of abdominal vascular collapse during pregnancy are uncertain due to its low incidence, we just have to keep reporting those cases to lead to disease enlightenment on both sides of patients and clinicians. When an unruptured SAA is incidentally found during pregnancy, some experts have recommended elective intervention using a minimally invasive approach (endovascular or laparoscopic) with appropriate timing [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the principal complaints in patients with SAA rupture are nonspecific, resulting in a clinical picture similar to that of other major obstetric complications [ 8 ]. In addition, abdominal computed tomography might be initially avoided even in cases of acute abdomen because of the radiation hazards during pregnancy [ 10 ]. Consequently, 70% of cases of SAA rupture during pregnancy have been primarily misdiagnosed as uterine rupture or placental abruption [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Splenic artery aneurysm rupture during pregnancy: A case report of maternal and fetal survival

Fujii

Yamashita

Fudono

et al. 2020

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Splenic artery aneurysm rupture during pregnancy: A case report of maternal and fetal survival

Fujii

Yamashita

Fudono

et al. 2020

International Journal of Surgery Case Reports

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“…Ruptured splenic artery aneurysm is associated with a 75% maternal mortality rate and up to 95% fetal mortality rate in the published works; therefore, a low index of suspicion is required to manage these rare cases with high mortality rates 2. A review of the literature and case reports shows the propensity for obstetric doctors to assume placental abruption and only to be faced with haemoperitoneum on laparotomy and later diagnosis of splenic artery aneurysm rupture 2–4. Intraoperative diagnosis of a ruptured splenic artery does not allow for preoperative multidisciplinary team (MDT) planning for such complex surgical cases to optimise outcomes.…”

Section: Introductionmentioning

confidence: 99%

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

et al. 2022

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This case of acute rupture of a splenic artery aneurysm in a patient 35 weeks pregnant demonstrates the difficulties in diagnosis and importance of multidisciplinary team management for surgical emergencies in pregnancy. A women in her early 30s presented at 35 weeks pregnant with sudden onset of severe epigastric pain and shortness of breath and was found to be tachycardic with a raised lactate. Differentials included a possible vascular event or pulmonary embolism. A CT scan demonstrated free fluid and likely ruptured splenic artery aneurysm. A rapid, thorough preoperative meeting enabled us to integrate multidisciplinary care effectively. She underwent coiling of her splenic artery, which was essential to reduce further intraoperative blood loss, followed by a midline incision for caesarean section of her baby and splenectomy. She had a long stay in the intensive care unit (ITU) and complex postoperative course but was discharged after 2 months to be reunited with her baby who was in good condition.

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“…There remains some debate as to optimal timing or size criteria regarding elective repair, and both open and endovascular techniques have shown to have good outcomes [3,[10][11][12][13]. One fact is clear, however: ruptured splenic artery aneurysm, especially in the setting of pregnancy can be disastrous [14,15].…”

Section: Introductionmentioning

confidence: 99%

A Unique Presentation of Splenic Artery Aneurysm During Pregnancy

Kania¹,

Hawkins²,

Sim³

et al. 2020

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Visceral arterial (VAA) and, specifically, splenic arterial aneurysms (SAA) are rare entities often associated with pregnancy. When ruptured, they can be fatal and require emergent management. This case report includes a review of the relevant literature and describes a unique, multidisciplinary approach to managing such an aneurysm. We describe the difficult situation of an already rupturing aneurysm and the careful coordination of obstetric, surgical, vascular, and interventional radiology teams. The distinctiveness of this case continues with the intraoperative finding of metallic coils freely protruding into the peritoneum from a recently coil-embolized ruptured splenic artery aneurysm. Such iatrogenic foreign bodies are a product of the integration of multiple specialities that can provide life-saving care when managing critical surgical disease such as ruptured splenic artery aneurysms. Multidisciplinary approaches should be considered depending upon the resources available at one's institution.

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Splenic artery aneurysms during pregnancy: An obstetric nightmare

Cited by 12 publications

References 16 publications

Splenic artery aneurysm rupture during pregnancy: A case report of maternal and fetal survival

Splenic artery aneurysm rupture during pregnancy: A case report of maternal and fetal survival

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

A Unique Presentation of Splenic Artery Aneurysm During Pregnancy

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