Abstract
Background: A ruptured splenic artery aneurysm is rare but potentially fatal and has a greater chance of occurring during pregnancy. Case: A 38-year-old pregnant woman was admitted to hospital in labor and presented with dyspnea and hypovolemic shock during the expulsion stage. After delivery, a bedside ultrasound was performed and showed a large amount of free fluid in the abdominal cavity. The patient was submitted to an exploratory laparotomy, which found a ruptured splenic hilum, and anatomopathological examination confirmed a ruptured splenic artery aneurysm. Both mother and baby survived without sequelae. Conclusion: Ruptured aneurysm must be considered among the causes of hypovolemic shock in pregnancy, and early detection can reduce the morbidity and mortality of this event.
Highlights
Splenic artery aneurysm is a rare condition with a prevalence of less than 1% in the general population and is more common in women; it is the third most common cause of intra-abdominal aneurysms and the most common among visceral arterial aneurysms[1]
After delivery, the rapid response team (RRT) was called and the patient was sent to the intensive care unit (ICU) on mechanical ventilation
Most of the cases are diagnosed after hemorrhagic hypovolemic shock sets in, due to ruptured aneurysm, which increases morbidity and mortality of this condition
Summary
Camila Karsburg Bessow[1], Rosi Pereira Balbinotto[1], Ana Lúcia Letti Müller[1], Jaqueline Neves Lubianca[2]. Splenic artery aneurysm is a rare condition with a prevalence of less than 1% in the general population and is more common in women; it is the third most common cause of intra-abdominal aneurysms and the most common among visceral arterial aneurysms[1]. This condition was first described by Beussier in 1770; some of the risk factors often described are: fibrodysplasia, portal hypertension, splenomegaly, cirrhosis of the liver, liver transplant, pancreatitis, vasculitis, infectious mononucleosis, and pregnancy[1,2,3,4,5,6].
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