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Splenic aneurysms in pregnancy

Melissa Sum, Jessica B Fleischer, Alexander G Khandji, Sharon L Wardlaw
Diabetes insipidus (DI) during pregnancy and the perinatal period is an uncommon medical problem characterized by polyuria and excessive thirst. Diagnosis of DI may be overlooked in the setting of pregnancy, a time when increased water intake and urine output are commonly reported. We report two cases: one of transient DI in a young woman during her third trimester of twin pregnancy in association with acute fatty liver and hypertension and one of postpartum DI secondary to Sheehan syndrome from rupture of a splenic artery aneurysm...
2017: Case Reports in Obstetrics and Gynecology
Elie Creidi, Antoine El Asmar, Rawad Abou Zahr, Ziad El Rassi
Pregnancy and giant splenic artery aneurysms should be addressed in a way to achieve optimal results for the mother and the fetus. In our case, the need for immediate intervention, with minimal risk, made open aneurysmectomy and distal splenopancreatectomy, the ideal approach to undertake.
July 2017: Clinical Case Reports
Julian Maingard, Hong Kuan Kok, Emma Phelan, Caitriona Logan, Dinesh Ranatunga, Duncan Mark Brooks, Ronil V Chandra, Michael J Lee, Hamed Asadi
INTRODUCTION: Visceral and renal artery aneurysms (VRAAs) are an uncommon clinical entity but carry a risk of rupture with associated morbidity and mortality. The rupture risk is particularly high when the aneurysms are large, of unfavourable morphology or in the setting of pregnancy and perioperative period. Endovascular approaches are now first line in the treatment of VRAA, but conventional techniques may be ineffective in excluding aneurysms with unfavourable anatomy such as those with wide necks or at arterial bifurcation points...
November 2017: Cardiovascular and Interventional Radiology
M J E van Rijn, S Ten Raa, J M Hendriks, H J M Verhagen
True visceral artery aneurysms (VAAs) are a rare entity with an incidence of 0.01-2%. The risk of rupture varies amongst the different types of VAAs and is higher for pseudo aneurysms compared with true aneurysms. Size, growth, symptoms, underlying disease, pregnancy and liver transplantation have all been associated with increased risk of rupture. Mortality rates after rupture are around 25%. The splenic artery is most commonly affected and the etiology is predominantly atherosclerosis. Open repair can be done by simple ligation or reconstruction of the artery, while endovascular options include embolization or using a stent graft...
February 2017: Best Practice & Research. Clinical Gastroenterology
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
June 2017: American Journal of Emergency Medicine
Jonathan D Monti
Splenic artery aneurysm rupture is rare. Pregnancy is a significant risk factor and the mortality for mother and fetus is very high if the rupture is undiagnosed or diagnosis is delayed. Patients typically present with abdominal pain and hemodynamic instability. This article describes a woman and fetus who survived a ruptured splenic artery aneurysm.
November 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Abidullah Khan, Maimoona Ayub, Iqbal Haider, Mohammad Humayun, Zakir Shah, Fahad Ajmal
BACKGROUND: Splenic artery aneurysms are the commonest visceral and third most common abdominal artery aneurysms, having a strong association with both pregnancy and multiparity. Here we report possibly the first case of a giant splenic artery aneurysm in association with a smaller portal vein aneurysm, in a woman who had never conceived, leading to non-cirrhotic portal hypertension. CASE PRESENTATION: A 40-year-old Pakistani Asian woman who had no evidence of liver cirrhosis presented in April 2016 for a diagnostic workup of ascites, massive splenomegaly, and pancytopenia...
September 29, 2016: Journal of Medical Case Reports
Daniel Martingano, Francis X Martingano, Rosemary Ruggiero-DeCarlo
Pregnancy-related rupture of an arterial aneurysm is an unusual occurrence associated with increased risk of morbidity and mortality. Various pregnancy-related physiologic changes appear to make pregnancy a high-risk situation for rupture of either preexisting arterial aneurysms or those that develop throughout the course of pregnancy. Splenic artery aneurysms are the most common (60%), followed by hepatic (20%), superior mesenteric (5.9%), celiac (4%), ovarian, uterine, and renal (<2%) artery. Even rarer are aneurysms involving the internal iliac artery and its branches, to which there is only one published case report...
September 2016: Obstetric Medicine
Jacqueline Parrish, Cynthia Maxwell, John Robert Beecroft
BACKGROUND: Splenic artery aneurysm (SAA), a rare condition chiefly affecting women, poses significant challenges for management when it occurs during pregnancy. Reports of successful management of SAA before rupture in pregnancy are limited, with several post-rupture cases reported. CASE: We describe the case of a woman with an SAA of 13 × 9 mm near the hilum of the spleen who subsequently became pregnant. Embolization of the splenic artery in the third trimester resulted in occlusion of the aneurysm but was followed three weeks later by a splenic abscess...
September 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Cergika Veluppillai, Sophie Perreve, Benoit de Kerviler, Guillaume Ducarme
The aneurysm of the splenic artery (SAA) is rare. His rupture is one cause of non-obstetrical hemoperitoneum and abdominal pain during pregnancy. The increased splanchnic and splenic arterial blood flow due to pregnant uterus by compression of the aorta and iliac vessels, and alterations of the arterial wall structures, induced by hormonal modifications, are thought to be the principal factor in SAA development and rupture. The emergency splenectomy during pregnancy has been reported in over 100patients in the literature and appears to be associated with a maternal mortality rate around 75% and a fetal mortality rate around 95%...
October 2015: La Presse Médicale
Tatjana Barišić, Nikica Šutalo, Ludvig Letica, Andrea Vladimira Kordić
Splenic artery aneurysm (SAA) is a rare and usually asymptomatic vascular anomaly which carries the risk of rupture and fatal hemorrhage. It is more common in women and is usually associated with pregnancy. We present the case of rupture of SAA, 5 days after giving birth by cesarean section, which was diagnosed with Multi-Slice Computed Tomografy (MSCT) angiography and was successfully operated in the second emergency laparotomy, with the final good outcome for the mother. This case indicates that in case of sudden bleeding in the abdomen, with the development of hypovolemic shock, especially in the peripartum period, should be suspected rupture of SAA...
November 2015: Wiener Klinische Wochenschrift
Héctor Bizueto-Rosas, José Ángel Barajas-Colón, Ivan Delgadillo-de la O, Nahieli Patricia Malo-Martínez, Hugo Alonso Pérez-González, Noemí Antonia Hernández-Pérez
BACKGROUND: Aneurysm of the splenic artery is diagnosed when the diameter of the splenic artery is greater than 1cm. It occupies third place among abdominal aneurysms. It is more frequent in women (4:1). It is associated with trauma, haemodynamics and local hormonal effects during pregnancy, portal hypertension (including the Caroli syndrome), arterial degeneration, atherosclerosis, and liver transplantation. It is difficult to diagnose, and it generally presents as ruptured, thus once the diagnosis is made, the surgical approach is indicated due to its high mortality...
January 2016: Cirugia y Cirujanos
B Le Tinier, C Jungo-Nançoz, C McCarey, N Jastrow
Splenic artery aneurysm (SAA) is the third most common intra-abdominal aneurysm. This condition, which occurs predominantly in young women, is generally asymptomatic and frequently discovered during pregnancy upon rupture. Reported maternal and fetal mortality are respectively 75% and 72.5-95%. A 40-year-old woman gravida 4 para 3 was referred to the obstetrical emergencies at term for loss of consciousness, nausea, vomiting, and hypotension. At admission, the patient had developed upper abdominal pain. Fetal demise and hemoperitoneum were diagnosed...
2015: Clinical and Experimental Obstetrics & Gynecology
A Papadomichelakis, D Anyfantakis, M Kastanakis, P Karona, E Bobolakis
Splenic artery aneurysms are unusual clinical conditions that may be ruptured resulting into adverse health outcomes. Pregnancy, portal hypertension and atherosclerosis are conditions that predispose to the formation of splenic artery aneurysms. A rare case of a previously healthy man referred to our department by his general practitioner complaining of acute abdominal pain is presented. During the hospital stay, the patient presented hemodynamic instability. Abdominal computed tomography disclosed perihepatic and perisplenic fluid accumulation...
2014: Journal of Medicine and Life
Anke C Heitkamp, Chris Dickhoff, Johanna H Nederhoed, Gaby Franschman, Johanna I de Vries
INTRODUCTION: The reported prevalence of a SAA varies between 0.01 and 10.4% [1], and since SAAs often remain asymptomatic, the true prevalence is uncertain. The reported SAAs occur more frequently in younger patients, with 58% diagnosed in women of childbearing age; 95% of these are diagnosed during pregnancy. PRESENTATION OF CASE: A 26-year-old woman, thirty-one weeks pregnant, was about to board an airplane for a three hour flight from the Netherlands to Turkey...
2015: International Journal of Surgery Case Reports
Elizabeth K Corey, Scott A Harvey, Lynnae M Sauvage, Justin C Bohrer
Background. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a significant maternal and fetal mortality. Case. A multiparous female presented in the third trimester with hypotension, tachycardia, and altered mental status. A ruptured splenic artery aneurysm was discovered at the time of laparotomy and cesarean delivery. The patient made a full recovery following resection of the aneurysm. The neonate survived but suffered severe neurologic impairment. Conclusion...
2014: Case Reports in Obstetrics and Gynecology
Akshatha Rao Aroor, Rama Prakasha S, Raghuraj U, Nazir Rahim Attar
A 39-year-old nulliparous female was admitted with massive splenomegaly. Computed tomography of abdomen revealed multiple aneurysms in the distal half of the splenic artery. Splenic artery aneurysms are rare in nulliparous women and most cases are reported in females with a past history of pregnancy. Splenic artery aneurysms, though very rare are clinically significant as they have a high propensity for fatal rupture. Here, we report a patient with multiple splenic artery aneurysms presenting as extrahepatic portal hypertension and massive splenomegaly...
September 2014: Journal of Clinical and Diagnostic Research: JCDR
Liliana Nanez, Martyn Knowles, J Gregory Modrall, R James Valentine
OBJECTIVE: Pregnancy is cited as the most important risk factor for splenic artery aneurysm (SAA) rupture, but the true rupture rate of SAAs during pregnancy is unknown. Our objective was to evaluate the prevalence of SAAs, based on diagnostic and procedural codes, in an urban population treated in a county hospital with the highest number of births in the United States. We hypothesized that SAA rupture in pregnant women is very low and that SAAs are more likely to be diagnosed in older patients...
December 2014: Journal of Vascular Surgery
Mary Lou Garey, Sarah Greenberger, Howard A Werman
No abstract text is available yet for this article.
September 2014: Air Medical Journal
M Rodríguez-Cordero, A González-Quintela, J A Díaz-Peromingo
Splenic artery aneurysm (SAA) is uncommon, but it is the most frequent visceral artery aneurysm. It is more common in women, especially during pregnancy. SAA is usually asymptomatic, but abdominal pain and rupture may develop. At present, computerized tomography (CT) angiogram is the best diagnostic test but not the only. Surgical or endovascular treatment may be considered both in symptomatic or asymptomatic aneurysms greater then 2 cm in diameter. We present the case of an elderly woman with an SAA and review the literature...
October 2014: Acta Clinica Belgica
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