Splenic Artery Aneurysm Rupture in a Parturient - Case Report

Abstract

Splenic artery aneurysm (SAA) is a rare clinical condition that is associated with a risk of rupture and catastrophic haemorrhage, and its incidence ranges between 0.01-0.09%.[1,2] Although a seemingly rare entity, SAA has been estimated to affect 20-40% of parturients with no other underlying medical problems.[3] This has been attributed to the various hormonal changes that accompany normal pregnancy. Rupture of SAA has been described as either a single precipitous event or a two-staged phenomenon with the bleed being initially contained in the lesser sac with an apparent antecedent haemodynamically stable phase followed by cataclysmic decompensation when the contained bleed leaks into the greater sac. This can take anything between 6 – 96 hours.[4] However, in pregnancy, this process can be rapid. We present one such case of a parturient, with initially preserved haemodynamics, followed by rapid decompensation, with ultimately good maternal and neonatal outcomes.