Wang Chenhong, Tu Xinzhi, Li Shengli, Luo Guoyang, Norwitz Errol R
Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China.
J Emerg Med. 2011 Nov;41(5):503-6. doi: 10.1016/j.jemermed.2010.05.075. Epub 2010 Sep 2.
Spontaneous (non-traumatic) rupture of the spleen rarely occurs in the setting of a normal spleen, especially during pregnancy.
We report a case of spontaneous rupture of a normal spleen at 33.7 weeks gestation and review the literature with the aim of exploring the etiology, diagnosis, and management of this condition during pregnancy.
A 30-year-old Chinese primigravida presented at 33.7 weeks gestation with acute onset of severe, constant left upper abdominal pain. She developed acute hypotension. Physical examination revealed diffuse abdominal tenderness with rebounding and guarding. An emergent cesarean delivery and abdominal exploration was performed. A non-viable male infant was delivered, and active bleeding was identified at the splenic hilum consistent with splenic rupture. A splenectomy was performed, and a consumptive coagulopathy was identified and treated. The patient had an uncomplicated postoperative course and was discharged home on postoperative day 15.
Splenic rupture in pregnancy is a life-threatening complication. Early diagnosis and aggressive surgical intervention will allow for optimal maternal and perinatal outcome.
正常脾脏自发性（非创伤性）破裂在孕期尤其罕见。
我们报告一例妊娠33.7周时正常脾脏自发性破裂的病例，并回顾文献以探讨孕期该疾病的病因、诊断及处理。
一名30岁的中国初产妇，妊娠33.7周时因急性发作的严重持续性左上腹疼痛就诊。她出现了急性低血压。体格检查发现全腹压痛伴反跳痛及肌紧张。紧急行剖宫产及腹部探查。娩出一名已无生命迹象的男婴，发现脾门处有活动性出血，符合脾破裂表现。行脾切除术，诊断并治疗了消耗性凝血病。患者术后恢复顺利，术后第15天出院。
孕期脾破裂是一种危及生命的并发症。早期诊断及积极的手术干预可实现最佳的母婴结局。
