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妊娠早期脾动脉瘤破裂:一种罕见且灾难性的事件。

Rupture of splenic artery aneurysm during early pregnancy: a rare and catastrophic event.

作者信息

Chookun Julien, Bounes Vincent, Ducassé Jean Louis, Fourcade Olivier

机构信息

Pôle d'Anesthésie Réanimation GRC BP 48 Université Paul Sabatier Toulouse, France.

出版信息

Am J Emerg Med. 2009 Sep;27(7):898.e5-6. doi: 10.1016/j.ajem.2008.10.039.

Abstract

Spontaneous rupture of splenic artery aneurysm during pregnancy is a rare, life-threatening event with a catastrophic prognosis. Splenic artery aneurysm, known to be more frequent in women, especially among multiparous ones, is generally asymptomatic until rupture. Because of increased blood flow and hormonal modifications, this rupture occurs frequently during pregnancy, most often at the end of the third trimester. We present the case of a second parous woman in early pregnancy with a rupture of splenic artery aneurysm initially diagnosed as a complicated ectopic pregnancy, which profoundly modifies surgical treatment. Through this case report, we want to draw attention to the fact that even if complicated ectopic pregnancy is much more frequent, ruptured splenic artery aneurysm (SAA) needs to be considered as a part of differential diagnosis of hemoperitoneum during the first trimester as well.

摘要

妊娠期脾动脉瘤自发性破裂是一种罕见的、危及生命的事件,预后极差。脾动脉瘤在女性中更为常见,尤其是经产妇,通常在破裂前无症状。由于血流量增加和激素变化,这种破裂在妊娠期经常发生,最常见于妊娠晚期。我们报告一例初孕妇早期脾动脉瘤破裂的病例,最初被诊断为复杂异位妊娠,这深刻改变了手术治疗方案。通过本病例报告,我们想提醒注意,即使复杂异位妊娠更为常见,但在孕早期,破裂的脾动脉瘤也应被视为腹腔积血鉴别诊断的一部分。

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