Spontaneous rupture of splenic artery aneurysm in a post-partum patient
Presentation
1 week post normal vaginal delivery, unable to open bowels or pass flatus, generalized abdominal pain with guarding suspected bowel obstruction.
Patient Data
A saccular distal splenic artery aneurysm measuring 2.0 x 1.8 x 2.4cm is noted with associated acute large retroperitoneal hemorrhage showing mass effect.
A small focus of internal thrombus is noted.
Post-partum uterus is noted.
Minimal free fluid in the pelvis.
Minimal bilateral pleural effusion.
Case Discussion
The patient was immediately taken for laparotomy, ligation of splenic artery aneurysm, splenectomy, and clearing of hemorrhage. The patient recovered following successful surgery.
Splenic artery aneurysm rupture carries a high mortality, particularly in patients with liver transplantation, portal hypertension, and pregnancy. The usual presentation is sudden onset abdominal pain followed by hemodynamic instability. Surgical treatment was considered in our patient based on her presentation.
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