Definition. Aneurysms of the splenic artery are a rare type of aneurysm that are often asymptomatic. Splenic artery aneurysms are usually asymptomatic or cause non-specific, mild abdominal symptoms until rupture occurs. There are several therapeutic approaches: endovascular surgery using coil . This increases disproportionately to 75% among pregnant women with fetal mortality of 95%. }, author={Yifat Wiener and Roni Tomashev and Ortal Neeman and Zalman Itzhakov and Eitan Heldenberg and Yaakov Melcer and Ron Maymon}, journal={European journal of . The indications and urgency for treating splenic aneurysms are well established, and when required, one must additionally consider pregnancy, surgery, endotechnology, and timing as factors. True splenic artery aneurysms (SAAs) involve all layers of the wall, each of which is intact and thinning. The patient was pain free at regular follow-up. Splenic artery aneurysms during pregnancy: An obstetric nightmare Health care providers and especially obstetricians should be aware of the diagnosis of ruptured SAA in a pregnant woman with abdominal discomfort and hemodynamic deterioration. There have been reports in the literature of improved outcomes with . Radiographic features Splenectomy and aneurysmectomy (note the surgical tie on splenic artery proximal to the aneurysm at the tail of pancreas). 2 Treatment options include surgery, percutaneous coil . Ruptured SAA has a mortality rate of up to 25%, with increased rates of rupture in pregnancy, pseudoaneurysm, liver . Results }, author={David M. Cressey and M F Reid}, journal={International journal of obstetric anesthesia}, year={1996}, volume={5 2}, pages={ 103-4 } } List key points in the assessment of abdominal pain during pregnancy. We aimed to evaluate risk factors, presentation, investigation, and management of SAA in pregnancy and puerperium. Multiple peripheral arteries were situated distal to the splenic artery aneurysm and might have been connected to the aneurysm. Abnormal glucose in pregnancy icd 10 Spleen pain pregnancy A forceful blow Spleen pain pregnancy your abdomen during a sporting accident, a fistfight or a car crash, for example is the Spleen pain pregnancy cause of a ruptured spleen. Splenic artery aneurysms (SAA) are more frequent in women and have a high rupture risk during pregnancy, with catastrophic outcomes. First described by Beaussier in 1770, approximately 400 cases have now been reported in the literature. Most are asymptomatic until rupture. 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. 1., 8., 16., 19. Nevertheless, splenic artery aneurysm rupture during pregnancy represents a serious potential threat to the health of the mother and the fetus. In order to help physicians take care of these patients to complete pregnancy and delivery successfully, we invited experts from the Department of Rheumatology and . Nachfrageschwankungen und der groe Wettbewerb IM Datenautobahn kmmern in Relation zu, dass sich die Preise z. T. jeden Tag verlegen. Rupture of a splenic artery aneurysm (SAA) is a rare condition that occurs predominantly in pregnancy. The discovery of a splenic artery aneurysm incidentally during pregnancy is worth considering. This case underscores the challenging anatomic considerations required for managing the anomalous splenic artery with aneurysm during late-term pregnancy. Pseudoaneurysms are the result of a tear in the . We report a case of ruptured splenic artery aneurysm during the third trimester of pregnancy with both maternal and fetal survival. SPLENIC ARTERY ANEURYSM What is the clinical importance of splenic artery aneurysm? Method: A series of four cases of splenic artery aneurysm diagnosed in pregnant or post-partum women at our University center between January 1998 and December 2020. Splenic artery aneurysms (SAA) are the most frequently encountered of the visceral aneurysms, with incidence rates up to 1% reported in the normal population. A rare cause of acute abdomen in pregnancy, is life-threatening abdominal hemorrhage due to rupture of a splenic artery aneurysm (SAA). EDITORIAL COMMENT: We accepted this rather detailed case report for publication because of the special relationship of rupture of splenic artery aneurysms with pregnancy. Splenic artery aneurysm (SAA) is an infrequent form of vascular disease that has a significant potential for rupture, resulting in life-threatening intraperitoneal hemorrhage commonly during pregnancy. (B) Wire was introduced to the artery at the lower pole, distal to the aneurysm. Pathology The size of splenic artery aneurysms can range from 2 to 9 cm, but usually, it is smaller than 3 cm. das bedeutet auch, dass wir die Auslese der jeweiligen Test- oder Vergleichsparameter stets hinterfragen und einzelne Datenpunkte nur dann in . Summary: Rupture of a splenic artery aneurysm during pregnancy . The majority of patients show no signs or symptoms [ 1 ]. Background: stroke is the second leading cause of death and disability worldwide. Obstetric triage revisited: Update on nonobstetric surgical conditions in pregnancy. Splenic artery aneurysms (SAA) are most commonly (60%) associated with a high mortality rate of 25% in case of aneurysm rupture. Study design The current manuscript describes three different events, treated in out our department, involving SAAs diagnosed during pregnancy. About. https://orcid.org. @article{Cressey1996SplenicAA, title={Splenic artery aneurysm rupture in pregnancy. Is screening justified? Pregnancy in patients with lupus is often associated with various risks such as disease activity, miscarriage or preterm delivery, and the selection of medications needed to control various abnormalities should be very careful. Those aneurysms are relatively rare with an incidence of 0.16-0.78% [1]. Aneurysms of the splenic artery are rare although they are the most common of the so-called visceral artery aneurysms. Splenic artery aneurysm rupture in pregnancy. 1 An SAA should be treated when its diameter is >2 cm, even if asymptomatic. Results: The first case is of a 25 week's gestation twin pregnancy with ruptured SAA ending in maternal and fetal death. The prevalence of splenic artery aneurysm is 0.04% to 0.10% at arteriography and autopsy. Objective: To describe four consecutive cases of splenic artery aneurysm with different clinical patterns of presentation among obstetric patients. Europe PMC is an archive of life sciences journal literature. Splenic artery aneurysm (SAA), a rare condition chiefly affecting women, poses significant challenges for management when it occurs during pregnancy. This case of acute rupture of a splenic artery aneurysm in a patient 35 weeks pregnant demonstrates the difficulties in diagnosis and importance of multidisciplinary team management for surgical emergencies in pregnancy. Objective: Splenic artery aneurysms (SAA) are associated with significant maternal and fetal mortality when ruptured in pregnancy. About Europe PMC; Preprints in Europe PMC; Funders; Joining Europe PMC; Governance . However, there is no consensus on the optimal obstetric management of both ruptured and asymptomatic SAA. To preserve the artery 4 mm covered stent (Bently) was deployed at the area of the aneurysm. Splenic artery aneurysms (SAA) are a rare and life-threatening pathology. Splenic artery aneurysms are the third most common form of abdominal visceral artery aneurysms following aortic and iliac artery aneurysms. Up to 95% of cases take place during pregnancy, particularly in third-trimester multiparous women, considered to be related to endocrine and mechanical causes ( 3 ). A splenic artery aneurysm is a bulging, weakened section of the artery that supplies blood to your spleen and parts of your pancreas and stomach. 2003; 48: 111-118. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a . Another case of SAA rupture presented at 27 week's gestation with. Spontaneous rupture of splenic artery aneurysm (SAA) is a catastrophic and potentially life-threatening complication of pregnancy, for both the pregnant mother and fetus; maternal and fetal mortality rates remain extremely high, up to 70% and 90% respectively [ 1 ], underlining the necessity of immediate intervention. About 6 h after arrival, the patient underwent relaparotomy with an upper midline incision. It occurs more frequently in younger females. This case report demonstrates that conservative management with monthly surveillance MRI can be used as viable treatment option of an asymptomatic 17 mm splenic artery aneurysm in a pregnant woman. It is associated with a maternal mortality rate of 75% and fetal mortality rate of 95% [ 1 ]. It manifests clinically as a yellow staining of the sclera, mucous membranes, skin and other tissues. Splenic artery aneurysm rupture during pregnancy is a rare, but potentially catastrophic event that requires the utmost skill and vigilance of an interdisciplinary team of health care . Visceral artery aneurysms are reportedly present in approximately 10% of autopsies. Sign in | Create an account. Europe PMC. The normal diameter of the splenic artery varies and ranges from 0.43 cm to 0.49 cm. An institutional review of splenic artery aneurysm in childbearing-aged females and splenic artery aneurysm rupture during pregnancy. }, author={Jacqueline Parrish and Cynthia V. Maxwell and J.R. Beecroft}, journal={Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC}, year={2015}, volume={37 9}, pages={ 816 . Download Citation | Splenic artery aneurysm in pregnancy: A systematic review | Background: Splenic artery aneurysms (SAA) are associated with significant maternal and fetal mortality when . @article{Parrish2015SplenicAA, title={Splenic Artery Aneurysm in Pregnancy. Many people have no symptoms, but a common symptom is pain in the upper left side of your belly. The incidence of splenic artery aneurysms has been estimated between 0.01% and 0.98%. Each case presents an unusual course and a unique clinical challenge. Overall maternal and fetal mortality in these cases has generally been accepted to approach 70% and 75%, respectively. Splenic artery aneurysm is the most common visceral artery aneurysm ( 1 - 3 ). The precise etiology of splenic aneurysms remains unclear. Menu. Google Scholar . Scribd is the world's largest social reading and publishing site. Reports of successful management of SAA before rupture in pregnancy are limited, with several post-rupture cases reported. The splenic artery is defined as aneurysmal when a focal dilation is observed in its diameter of greater than 50% compared to the normal vessel diameter. Splenic artery aneurysms (SAA) are the third most common type of arterial aneurysm, with diameters ranging from 0.6 to 30 cm. 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. Different etiological factors attributed to aneurysm formation include angiodysplasia, portal hypertension, pregnancy, atherosclerosis, diabetes, intracranial aneurysm, polyarteritis nodosa, alpha-1-antitrypsin deficiency and infective factors. A women in her early 30s presented at 35 weeks pregnant with sudden onset of severe epigastric pain and shortness of breath and was found to be tachycardic with a raised lactate. Splenic Artery Aneurysm in Pregnancy. Journal of Nurse Midwifery. (A) Selective splenic artery angiography via right common femoral artery access revealed two aneurysms in the upper and lower branches of the splenic artery. However, there is no consensus on the optimal obstetric management of both ruptured and asymptomatic SAA. Visceral artery aneurysm is an uncommon pathology, with a potential for rupture. Peripheral calcification is common, and mural thrombus may be present 12 . The highest risk of rupture for a splenic artery aneurysm is during the third trimester, accounting for 69% of ruptures, typically in the last two weeks of pregnancy; 12% of ruptures occur during the 1 st and 2 nd trimesters, and 13% occur during labor with 6% occurring postpartum [10-13]. DOI: 10.1016/j.ejogrb.2019.04.029 Corpus ID: 140350103; Splenic artery aneurysms during pregnancy: An obstetric nightmare. 2. Operative finding of a splenic artery aneurysm within the hilum of spleen with very thin wall (impending rupture). This is the most common visceral artery aneurysm reported making up about 60% to 70% of patients diagnosed with visceral artery aneurysms. Figure 4. The estimated prevalence of splenic artery aneurysms (SAAs) is 60% among visceral artery aneurysms with a rupture rate of 25% and mortality rate of up to 70% after rupture. There are many different faces to how a splenic . Risk factors for aneurysm formation and rupture include pregnancy and portal hypertension. It is often found incidentally, but accounts for about 60% of visceral arterial aneurysms. Jaundice can also occur in certain hematologic diseases, pancreatic diseases, obstetric diseases, and neonatal diseases (congenital . 1 The most devastating complication of SAA is rupture, an event conferring mortality rates of approximately 25%. 2, . Objectives Upon completion of this activity, the learner will be able to : Describe risk factors, management and sequelae of splenic artery aneurysm rupture during pregnancy. During irrigation of the space in the lesser sac, which was full of blood, sudden cardiac arrest occurred. We aimed to evaluate risk factors, presentation, investigation, and management of SAA in pregnancy and puerperium. Availability of data and materials Abstract and Figures Background: Splenic artery aneurysm (SAA), a rare condition chiefly affecting women, poses significant challenges for management when it occurs during pregnancy.. In turn, three SAA cases were unknown: two manifested with maternal collapse due to spontaneous rupture of the aneurysm during pregnancy, leading to maternal death in one case and stillbirth in the other, whereas one . During pregnancy, splenic artery aneurysms are prone to rupture in the third trimester or in the puerperium because of the heightened circulating levels of estrogen, progesterone, and relaxin, in addition to maternal physiological changes, which increase arterial stress.2Previous reports describe high maternal (75%) and fetal (95%) CONCLUSION Case Presentation Jaundice (jaundice) is a common symptom and sign that occurs as a result of elevated bilirubin concentrations in the serum due to impaired bilirubin metabolism. SAA is a rare and life-threatening . It is advisable to treat these aneurysms in pregnant and fertile women, whatever its diameter, given its increased risk for rupture. In this study we report our experience in the management of Splenic Artery Aneurysm (SAA), diagnosed during pregnancy. Splenic artery aneurysms (SAA) are associated with significant maternal and fetal mortality when ruptured in pregnancy. It is wise for obstetricians to know that this condition is an important uncommon cause of abdominal pain and collapse during pregnancy, labour or the puerperium.