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Splenic aneurysms in pregnancy

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
Airazat M Kazaryan, Joachim Wiborg, Kristin Hauss, Tommy K Anundsen, Olav J Flemmen, Thor Erik Holm, Giedrius Lauzikas
PATIENT: Female, 28 FINAL DIAGNOSIS: Rupture of the splenic artery aneurysm Symptoms: Hypovolemic shock Medication: - Clinical Procedure: - Specialty: Surgery. OBJECTIVE: Rare disease. BACKGROUND: ATLS principles have become a standard of care for trauma patients. However, there is poor documentation in regard to spontaneous non-traumatic life-threatening bleedings. CASE REPORT: Two women, a 21-year-old and a 28-year-old, presented to the admissions department in hemorrhagic shock...
2014: American Journal of Case Reports
Hope T Jackson, Silviu C Diaconu, Patrick J Maluso, Bruce Abell, Juliet Lee
Nontraumatic symptomatic hypotension in all patients requires prompt diagnosis and appropriate treatment for optimum outcome. The female population specifically has an expanded differential diagnosis that should be considered when these patients present with hemodynamic collapse. While the most common causes of hypotension in pregnant patients are dehydration, ruptured ectopic pregnancy, and placental and uterine abnormalities, less common nonobstetrical etiologies such as hepatic rupture and ruptured abdominal and visceral artery aneurysms should also be considered...
2014: Case Reports in Emergency Medicine
Marie-Eve Bergeron, Tim Child, Muhammad Fatum
Ehlers-Danlos syndrome (EDS) is an autosomal dominant connective tissue disorder with one of the highest maternal mortality rates of any condition. Patients with the vascular type of EDS are prone to spontaneous arterial and visceral ruptures. The occurrence of these severe and life-threatening complications is increased in pregnancy. Moreover, these patients carry a 50% risk of having an affected child. However, little is known about the risks of assisted conception treatments on these patients. We present the case of a 33-year-old woman suffering from EDS with a history of repeated ruptures of arterial aneurysms and a recently ruptured aneurysm of the splenic artery during her first intracytoplasmic sperm injection (ICSI) cycle who was then advised to undergo only unstimulated cycles...
June 2014: Human Fertility: Journal of the British Fertility Society
Cathi Phillips, Jean Bulmer
Abdominal pain is commonly reported by women seeking care in obstetric triage, and although it it is often benign, careful assessment is warranted. A rare cause of left upper quadrant pain during pregnancy is splenic artery aneurysm rupture, which can result in massive hemorrhage and maternal and fetal mortality. In women who survive, serious complications from bleeding and multiple transfusions require intensive care. There have been reports in the literature of improved outcomes with utilization of hemostatic resuscitation protocols...
December 2013: Nursing for Women's Health
Ghassan M Hammoud, Ashraf A Almashhrawi, Khulood T Ahmed, Rubayat Rahman, Jamal A Ibdah
Pregnancy in patients with advanced liver disease is uncommon as most women with decompensated cirrhosis are infertile and have high rate of anovulation. However, if gestation ensued; it is very challenging and carries high risks for both the mother and the baby such as higher rates of spontaneous abortion, prematurity, pulmonary hypertension, splenic artery aneurysm rupture, postpartum hemorrhage, and a potential for life-threatening variceal hemorrhage and hepatic decompensation. In contrary, with orthotopic liver transplantation, menstruation resumes and most women of childbearing age are able to conceive, give birth and lead a better quality of life...
November 21, 2013: World Journal of Gastroenterology: WJG
Eleanor Oakley, Jeffrey D Ho, Valerie Johnson, Joan Vancamp, Taj Melson, John L Hick
BACKGROUND: Splenic artery aneurysm ruptures are rare and highly morbid events that are frequently associated with pregnancy. However, approximately 15% may occur in men, and it is important to have this possibility in the differential diagnosis in cases of hemoperitoneum and hemorrhagic shock. Rapid diagnosis and treatment is essential to survival. OBJECTIVES: The aim of this report is to educate emergency physicians on the early recognition and treatment of this life-threatening event and to increase the awareness of this condition in male patients...
March 2014: Journal of Emergency Medicine
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