October 18th, 2018

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Double Ruptured Splenic Artery Aneurysm in Pregnancy: A Case Report
Authors:  Nadav Cohen, M.D., Steven Warsof, M.D., Inbar Ben Shachar, M.D., and David Peleg, M.D.
BACKGROUND: Splenic artery aneurysm (SAA) rupture is a rare and potentially catastrophic event for the mother and the fetus. The rupture can be masked by a temporary arterial tamponade, referred to as the double rupture phenomenon.

CASE: A 32-year-old woman, G5 P2022, at 34 weeks’ gestation presented with moderate diffuse abdominal pain. Although initially stable, a falling hematocrit led to emergent primary cesarean delivery and exploratory laparotomy. A large blood clot was discovered tamponading a ruptured SAA located close to the splenic hilum, which ultimately led to splenectomy.

CONCLUSION: Temporary stability due to arterial tamponade of a ruptured SAA may delay the correct diagnosis, especially in pregnancy. Treatment usually includes laparotomy with splenic artery repair or splenectomy.
Keywords:  aneurysm; aneurysm, ruptured; double rupture; pregnancy; pregnancy complications; spleen
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