Ruptured splenic artery aneurysm in pregnancy. Twelfth reported case with maternal and fetal survival

Ruptured splenic artery aneurysm during pregnancy is a rare event with catastrophic consequences. This presentation is the twelfth case during pregnancy reporting survival of both mother and fetus. The literature reports a 25% mortality rate for ruptured splenic artery aneurysm. The mortality rate among pregnant women is disproportionately high at 75% with a fetal mortality rate of 95%. Gestational alterations that increase with parity are significant in the pathophysiologic characteristics of this condition. A unique double-rupture phenomenon may provide temporary tamponade with resolution of symptoms. A diagnosis of ruptured splenic artery aneurysm should be considered in any pregnant patient who complains of the sudden onset of severe left upper-abdominal pain regardless of whether pain or shock is prominent at the time of evaluation. Early consideration of a diagnosis of ruptured splenic artery aneurysm significantly increases the likelihood that the mother and fetus will survive.