Case Report: Successful embolisation of a ruptured splenic artery aneurysm in pregnancy

Background: A case study of a successfully treated rupture of a splenic artery aneurysm during pregnancy, an exceedingly rare condition. The natural history, typical presentation, epidemiology, investigations and available treatments are discussed. Case: A multigravid 37-year-old presented with acute left upper quadrant pain in her twentieth week of pregnancy. After resuscitation and emergency imaging the patient was diagnosed with a ruptured splenic artery aneurysm. Remaining stable after initial resuscitation allowed for endovascular coiling of her aneurysm. Discussion: The presentation of ruptured splenic artery aneurysm is rare. While pregnancy is a risk factor, it represents less than 0.1% of pregnancies. However, when it does present it is associated with a high maternal and foetal mortality rate. In this case the stability of the patient allowed for imaging to confirm the diagnosis and the provision of endovascular coiling of the aneurysm. On review of the literature the condition characteristically is diagnosed at laparotomy.