Rami A Ballout, Rayan Ghanem, Anwar Nassar, Ali H Hallal, Labib M Ghulmiyyah
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引用次数: 0
摘要
本病例是一名 38 岁的黎巴嫩妇女,G2P1,既往有剖宫产史,妊娠 30+5 周时出现急性左侧腹痛,两天前出现寒战和排尿困难。根据临床表现,患者最初被诊断为肾盂肾炎,并接受了相应的治疗;然而,尽管采取了抢救措施并进行了正常的腹部超声波检查,患者的临床状况还是恶化了,低血压和嗜睡症状不断加重。由于抢救无效,患者最终心脏骤停,在床边进行了剖腹产手术。进入腹腔后,发现了一个活跃出血的脾动脉瘤(SAA)破裂,为此启动了大量输血方案,并将患者转入手术室。患者术后病程复杂,胎儿胎死腹中,住院 6 个月后出院回家。鉴于妊娠期 SAA 破裂的高死亡率和发病率,早期识别和及时干预对孕产妇和胎儿的获益至关重要。
Splenic Artery Aneurysm (SAA) Rupture in Pregnancy: A Case Report of a Rare but Life-Threatening Obstetrical Complication.
This is the case of a 38 year-old Lebanese woman G2P1, history of previous cesarean section, presenting at 30+5 weeks of gestation with acute left-sided flank pain and a two-day history of chills and dysuria. In light of the clinical presentation, the patient was initially diagnosed with pyelonephritis and managed accordingly; however, her clinical status deteriorated with worsening hypotension and lethargy despite resuscitative measures and a normal abdominal ultrasound. Failure to revive the patient eventually led to a cardiac arrest for which a peri-mortem cesarean section was performed at bedside. Upon abdominal entry, an actively-bleeding ruptured splenic artery aneurysm (SAA) was identified, for which massive transfusion protocol was activated, and the patient was transferred to the operating room. The patient had a complicated postoperative course, the fetus was stillborn, and she was discharged home after 6 months of hospital stay. In view of the high mortality and morbidity associated with ruptured SAA in pregnancy, early recognition and prompt intervention are crucial for maternal and fetal benefit.