[Postpartum rupture of an aneurysm of the arteria lienalis].

Spontaneous rupture of a splenic artery aneurysm is a very rare but severe complication after delivery associated with a high mortality. We describe a case of a 27-year-old woman with severe left upper abdominal pain and progredient shock symptoms after uncomplicated delivery. Due to a double-rupture phenomenon with bleeding into the bursa omentalis and subsequent intraabdominal haemorrhage, the shock symptoms showed a biphasic time course that was moderate in the beginning but deteriorated dramatically within a few minutes. Intraabdominal bleeding was verified by transabdominal echography only at the time of circulatory decompensation. Ruptured splenic artery aneurysm was diagnosed after emergency laparotomy for suspected intraabdominal haemorrhage. The aetiology and pathophysiology, time course, differential diagnosis of the disease and patient outcome are discussed in this case report. Early consideration of a diagnosis of a ruptured splenic artery aneurysm as opposed to other critical postpartal conditions might increase the likelihood of survival of the affected women.