Caillouette J C, Merchant E B
Huntington Memorial Hospital, Pasadena, CA.
Am J Obstet Gynecol. 1993 Jun;168(6 Pt 1):1810-1; discussion 1811-3. doi: 10.1016/0002-9378(93)90694-e.
Ruptured splenic artery aneurysm during pregnancy is a rare event with catastrophic consequences. This presentation is the twelfth case during pregnancy reporting survival of both mother and fetus. The literature reports a 25% mortality rate for ruptured splenic artery aneurysm. The mortality rate among pregnant women is disproportionately high at 75% with a fetal mortality rate of 95%. Gestational alterations that increase with parity are significant in the pathophysiologic characteristics of this condition. A unique double-rupture phenomenon may provide temporary tamponade with resolution of symptoms. A diagnosis of ruptured splenic artery aneurysm should be considered in any pregnant patient who complains of the sudden onset of severe left upper-abdominal pain regardless of whether pain or shock is prominent at the time of evaluation. Early consideration of a diagnosis of ruptured splenic artery aneurysm significantly increases the likelihood that the mother and fetus will survive.
妊娠期间脾动脉动脉瘤破裂是一种罕见事件，会带来灾难性后果。本病例报告是妊娠期间第十二例母婴均存活的情况。文献报道脾动脉动脉瘤破裂的死亡率为25%。孕妇中的死亡率极高，达75%，胎儿死亡率为95%。随产次增加而出现的妊娠改变在该病症的病理生理特征中具有重要意义。一种独特的双重破裂现象可能会提供暂时的压迫止血并使症状缓解。对于任何主诉严重左上腹突发疼痛的孕妇，无论评估时疼痛或休克是否突出，均应考虑脾动脉动脉瘤破裂的诊断。早期考虑脾动脉动脉瘤破裂的诊断可显著增加母婴存活的可能性。
