A rare cause of maternal and fetal mortality by rupture of splenic artery aneurysm – a case report
Keywords:
Splenic artery aneurysm, Aneurysmal rupture, Visceral artery aneurysm, Maternal mortality, Fetal mortalityAbstract
A 26 year old pregnant female was brought unresponsive to the hospital with alleged history of loss of consciousness fol lowing giddiness. On examination, pulse was not palpable and blood pressure was not recordable. Inspite of all the resus citative measures, she could not be revived. Fetal bradycardia was detected with doppler and emergency perimortem Caesarean Section was done. But the fetus was still born. At the autopsy of the mother, spleen was found to be enlarged with multiple areas of hemorrhage. The splenic artery was seen to be tortuous and showed an area of aneurysmal dilata tion and rupture, 3cm proximal to hilum with surrounding peri-pancreatic hematoma. Peritoneal cavity contained one litre of fluid blood with blood clots in the lesser sac. Histopathological examination revealed arterio-venous malforma tion in the spleen with large areas of haemorrhage. Splenic artery aneurysm is a rare clinical entity that carries the risk of rupture and fatal hemorrhage. Ruptured splenic artery aneurysm can be disastrous for both the mother and fetus
References
Feo CF, Scanu AM, Fancellu A, Costantino S. Visceral aneurysm and vascular anomaly involving the splenic artery. Digestive Diseases and Sciences. 2004;49(9):1378-1380.
Al-Habbal Y, Christophi C, Muralidharan V. Aneurysms of the splenic artery – a review. Surgeon. 2010 Aug;8(4):223-231.
Lo WL, Mok KL. Ruptured splenic artery aneurysm detected by emergency ultrasound – a case report. Crit Ultrasound J. 2015 Dec;7(1):26.
Standring S, Ellis H, Healy J, Johnson D, Williams A, Collins P, Wigley C. Gray’s anatomy: the anatomical basis of clinical practice. Am J Neuroradiol. 2005 Nov;26(10):2703.
Dolinak D, Matshes E, Lew EO. Forensic pathology: principles and practice. Elsevier; 2005 Apr 8.
Samberkar PN, Chow TK, Samberkar SP. Fatal spontaneous rupture of splenic artery aneurysm in third trimester pregnancy. Malays J Pathol. 2018 Dec 1;40(3):337-341.
Abdulrahman A, Shabkah A, Hassanain M, Aljiffry M. Ruptured spontaneous splenic artery aneurysm: a case report and review of the literature. Int J Surg Case Rep. 2014 Jan 1;5(10):754-757.
Pasha SF, Gloviczki P, Stanson AW, Kamath PS. Splanchnic artery aneurysms. Mayo Clin Proc. 2007 Apr;82(4):472-479.
He MX, Zheng JM, Zhang SH, Wang JJ, Liu WQ, Zhu MH. Rupture of splenic artery aneurysm in pregnancy: a review of the literature and report of two cases. Am J Forensic Med Pathol. 2010 Mar 1;31(1):92-94.
