Splenic artery aneurysm in obstetrical patients: A series of four cases with different clinical presentation and outcome

Ornaghi, Sara; Crippa, Isabella; Nicola, Sara Di; Giardini, Valentina; Milia, Laura La; Locatelli, Luca; Corso, Rocco; Roncaglia, Nadia; Vergani, Patrizia

doi:10.1002/ijgo.14133

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…Imaging by CT or MRI in hemodynamically stable patients can allow not only prompt diagnosis of SHiP but also provide additional information regarding the bleeding site. Thus facilitating differential diagnosis with other SHiP-associated life-threatening conditions, such as the first stage of splenic artery aneurysm rupture, 8,13,14 and allowing for adequate and timely intervention to ensure optimal outcomes. In our series, we performed three emergency surgeries without further radiological assessment other than ultrasound because of fetal bradycardia (cases n.IV, V) and hypovolemic shock (case n.VI).…”

Section: Discussionmentioning

confidence: 99%

Endometriosis‐related spontaneous hemoperitoneum in pregnancy: A case series

Bazzurini

Ornaghi

Colciago

et al. 2022

J of Obstet and Gynaecol

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Endometriosis can be associated with adverse pregnancy outcomes. We report six cases of endometriosisrelated spontaneous hemoperitoneum diagnosed in pregnant and postpartum women over 13 years. Spontaneous hemoperitoneum in pregnancy mainly occurred in the second half of gestation. All women presented with acute abdominal pain; four of them needed an emergent surgery, two were managed expectantly. The median estimated blood loss was 4250 ml, four women required massive transfusion. Three out of six women had a known history of endometriosis, all of them had histologically confirmed endometriosis after surgery. No maternal or perinatal deaths occurred. In one case, reticence to perform a computed tomography scan led to delayed diagnosis. Since delay can lead to lethal consequences, high levels of suspicion for spontaneous hemoperitoneum should be maintained in cases of severe abdominal pain, even with a woman's negative history of endometriosis. Improved knowledge and regular interdisciplinary meetings are pivotal to ameliorate outcomes.

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Section: Discussionmentioning

confidence: 99%

Endometriosis‐related spontaneous hemoperitoneum in pregnancy: A case series

Bazzurini

Ornaghi

Colciago

et al. 2022

J of Obstet and Gynaecol

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“…12 ) to assess ascites, portal vein thrombosis, and new or growing focal lesions. Spontaneous rupture of a splenic artery aneurysm is a rare event found in 0.00001–0.003% of cases [ 89 ]. Maternal and fetal survival is 26% in the mother and 50% in the fetus and depends on a rapid diagnosis and effective treatment.…”

Section: Coincidental Liver Diseasesmentioning

confidence: 99%

“…Maternal and fetal survival is 26% in the mother and 50% in the fetus and depends on a rapid diagnosis and effective treatment. It mainly occurs in the second half of pregnancy or during labor [ 89 , 90 ]. Pregnancy, hyperdynamic circulation, and hormone-induced alterations of the arterial walls are contributing factors.…”

Section: Coincidental Liver Diseasesmentioning

confidence: 99%

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Liver imaging and pregnancy: what to expect when your patient is expecting

Porrello,

Cannella,

Bernuau

et al. 2024

Insights Imaging

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Liver diseases in pregnancy can be specific to gestation or only coincidental. In the latter case, the diagnosis can be difficult. Rapid diagnosis of maternal-fetal emergencies and situations requiring specialized interventions are crucial to preserve the maternal liver and guarantee materno-fetal survival. While detailed questioning of the patient and a clinical examination are highly important, imaging is often essential to reach a diagnosis of these liver diseases and lesions. Three groups of liver diseases may be observed during pregnancy: (1) diseases related to pregnancy: intrahepatic cholestasis of pregnancy, pre-eclampsia, eclampsia, hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and acute fatty liver of pregnancy; (2) liver diseases that are more frequent during or exacerbated by pregnancy: acute herpes simplex hepatitis, Budd-Chiari syndrome, hemorrhagic hereditary telangiectasia, hepatocellular adenoma, portal vein thrombosis, and cholelithiasis; (3) coincidental conditions, including acute hepatitis, incidental focal liver lesions, metabolic dysfunction–associated steatotic liver disease, cirrhosis, hepatocellular carcinoma, liver abscesses and parasitosis, and liver transplantation. Specific knowledge of the main imaging findings is required to reach an early diagnosis, for adequate follow-up, and to avoid adverse consequences in both the mother and the fetus.Critical relevance statement Pregnancy-related liver diseases are the most important cause of liver dysfunction in pregnant patients and, in pregnancy, even common liver conditions can have an unexpected turn. Fear of radiations should never delay necessary imaging studies in pregnancy.Key points• Pregnancy-related liver diseases are the most frequent cause of liver dysfunction during gestation.• Fear of radiation should never delay necessary imaging studies.• Liver imaging is important to assess liver emergencies and for the diagnosis and follow-up of any other liver diseases.• Common liver conditions and lesions may take an unexpected turn during pregnancy.• Pregnancy-specific diseases such as pre-eclampsia and HELLP syndrome must be rapidly identified. However, imaging should never delay delivery when it is considered to be urgent for maternal-fetal survival. Graphical Abstract

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Splenic vein rupture in pregnancy: A case report and systematic review of the literature

Kane,

Keaney,

Tunney

et al. 2024

Intl J Gynecology & Obste

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Splenic vein aneurysm (SVA) rupture is a rare clinical entity, with few case reports detailing its occurrence during pregnancy. We describe a case of a SVA rupture and present a systematic review of the literature in relation to splenic vein rupture, with or without aneurysm. Our case was of a 30‐year‐old woman, Para 4 at 37 weeks' gestation who presented with significant abdominal pain and subsequent maternal collapse. Massive intra‐abdominal hemorrhage was identified, with splenic vessel rupture suspected. A splenectomy and partial pancreatectomy were performed along with massive blood product transfusion. There was both maternal and fetal survival with no long‐term sequelae at follow‐up. Histological examination of the spleen and its vessels noted a SVA rupture. In a subsequent systematic review of the literature, we identified 10 cases of splenic vein rupture with only two previously documented cases of SVA rupture in pregnancy. Maternal and fetal survival has only been reported in two cases of splenic vein rupture, with ours being a third.

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Splenic artery aneurysm in obstetrical patients: A series of four cases with different clinical presentation and outcome

Cited by 4 publications

References 31 publications

Endometriosis‐related spontaneous hemoperitoneum in pregnancy: A case series

Endometriosis‐related spontaneous hemoperitoneum in pregnancy: A case series

Liver imaging and pregnancy: what to expect when your patient is expecting

Splenic vein rupture in pregnancy: A case report and systematic review of the literature

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