• Goran Augustin


Almost all surgical complications related to spleen during pregnancy include significant intraperitoneal bleeding. The symptoms commonly include acute and severe abdominal pain with progression to hypovolemic shock. The problem is that these patients do not have any underlying disease or did not have similar symptoms previously. If abdominal trauma is not the cause, abdominal sonography rarely finds the cause of free intraperitoneal fluid. Emergency exploration is the mainstay of therapy to find the cause and stop the bleeding. Currently, interventional radiologic techniques are used to stop splenic bleeding if diagnosed, with the advantage of avoidance of surgical operation. If interventional radiologic techniques are not successful, surgery for the cessation of bleeding, commonly in a form of splenectomy, is the ultimate measure. The diagnosis of splenic bleeding and intervention should be made early to save not only the fetus but also the mother.


  1. 1.
    Eastman NJ, Hellman L, editors. Williams obstetrics. 12th ed. New York: Appleton-Century-Crofts, Inc; 1961. 853 p.Google Scholar
  2. 2.
    Schwing C. Ruptur der Milz während der Schwangerschaft. Ein Beitrag zur Ätiologie des plötzlichen Todes während der Schwangerschaft. Zentralbl Gynakol. 1880;4:291.Google Scholar
  3. 3.
    Simpson J. On morbid conditions and injuries of the spleen in the pregnant and parturient states. Edinb Med J. 1866;268.Google Scholar
  4. 4.
    Hubbard. Rupture of the spleen after labor. N Y J Med. 1879;30:75.Google Scholar
  5. 5.
    Sparkman R. Rupture of the spleen in pregnancy. Am J Obstet Gynecol. 1958;76:587–98.CrossRefPubMedGoogle Scholar
  6. 6.
    Buchsbaum H. Splenic rupture in pregnancy: report of a case and review of the literature. Obstet Gynecol Surv. 1967;22:381–95.CrossRefPubMedGoogle Scholar
  7. 7.
    Bljajic D, Ivanisevic M, Djelmis J, et al. Splenic rupture in pregnancy—traumatic or spontaneous event? Eur J Obstet Gynecol Reprod Biol. 2004;115:113–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Aubrey-Bassler FK, Sowers N. 613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review. BMC Emerg Med. 2012;12:11.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Schamaun M. Die Zweitzeitige traumatische Milzrupturen. Helv Chir Acta. 1962;29:560–75.PubMedGoogle Scholar
  10. 10.
    Schonwerth K. Uber subkutane Milzrupturen. Dtsch Med Wochenschr. 1902;28:446–8.CrossRefGoogle Scholar
  11. 11.
    Lamerton A. Spontaneous rupture of the spleen in early pregnancy. Postgrad Med J. 1983;59:596–7.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Campbell W. Rupture of haemangioma of the spleen in pregnancy. J Obstet Gynaecol Br Emp. 1962;69:665–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Simpson C. Splenic rupture in pregnancy. Postgrad Med J. 1984;60:504.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Christau S, Klebe J. Rupture of the spleen during delivery. Acta Obstet Gynecol Scand. 1978;57:187–8.CrossRefPubMedGoogle Scholar
  15. 15.
    McCormick GM, Young D. Spontaneous rupture of the spleen. A fatal complication of pregnancy. Am J Forensic Med Pathol. 1995;16:132–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Denehy T, McGrath EBJ. Splenic torsion and rupture in pregnancy. Obstet Gynecol Surv. 1988;43:123–31.CrossRefPubMedGoogle Scholar
  17. 17.
    Kaluarachchi A, Krishnamurthy S. Post-cesarean section splenic rupture. Am J Obstet Gynecol. 1995;173:230–2.CrossRefPubMedGoogle Scholar
  18. 18.
    Bhagrath R, Bearn P, Sanusi F, et al. Postpartum rupture of the spleen. BJOG. 1993;100:954–5.CrossRefGoogle Scholar
  19. 19.
    Hamedi B, Shomali Z. Postpartum spontaneous rupture of spleen in a woman with severe preeclampsia: case report and review of the literature. Bull Emerg Trauma. 2013;1:46–8.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Adam I, Adam E. Spontaneous splenic rupture in a pregnant Sudanese woman with Falciparum malaria: a case report. East Mediterr Health J. 2007;13:735–6.PubMedGoogle Scholar
  21. 21.
    Bayer S. Przypadek tzw. samoistnego pekniecla sledziony u clezarnie. Pol Przegl Chir. 1956;28:83–5.PubMedGoogle Scholar
  22. 22.
    Mollegaard H. Ruptura lienis in graviditate. Nord Med. 1960;64:850–1.PubMedGoogle Scholar
  23. 23.
    Saavedra R. Spontaneous rupture of the spleen with subacute bacterial endocarditis. Illinois Med J. 1965;127:279–82.Google Scholar
  24. 24.
    Boldorini R, Bozzola C, Gallarotti E, et al. Fatal splenic rupture in a pregnant woman with hemoglobin C/beta-thalassemia and myeloid metaplasia. Arch Pathol Lab Med. 2006;130:1231–2.PubMedGoogle Scholar
  25. 25.
    Conner LA, Downes W. Spontaneous rupture of the spleen in typhoid fever, with report of a case cured by operation. Am J Med Sci. 1914;157:332–44.CrossRefGoogle Scholar
  26. 26.
    Debnath D, Valerio D. A traumatic rupture of the spleen. J R Coll Surg Edinb. 2002;47:437–45.PubMedGoogle Scholar
  27. 27.
    Babson WW, Morgan P. Spontaneous rupture of the apparently normal spleen. Am J Surg. 1946;72:97–102.CrossRefPubMedGoogle Scholar
  28. 28.
    Nelson JH Jr, Hall J. Studies on the thymolymphatic system in humans. I. Morphologic changes in lymph nodes in pregnancy at term. Am J Obstet Gynecol. 1964;90:482–4.CrossRefPubMedGoogle Scholar
  29. 29.
    Orloff MJ, Peskin G. Spontaneous rupture of the normal spleen; a surgical enigma. Int Abstr Surg. 1958;106:1–11.PubMedGoogle Scholar
  30. 30.
    Sheehan HL, Falkiner N. Splenic aneurysm and splenic enlargement in pregnancy. BMJ. 1948;2:1105–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Zuckerman IC, Jacobi M. Spontaneous rupture of the normal spleen. Arch Surg. 1937;34:917–28.CrossRefGoogle Scholar
  32. 32.
    Wang C, Tu X, Li S, et al. Spontaneous rupture of the spleen: a rare but serious case of acute abdominal pain in pregnancy. J Emerg Med. 2011;41:503–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Hershey FB, Lubitz J. Spontaneous rupture of the malarial spleen: case report and analysis of 64 reported cases. Ann Surg. 1948;127:40–57.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Stretton J. Abdominal cases illustrating important surgical principles. BMJ. 1926;1:901.CrossRefPubMedGoogle Scholar
  35. 35.
    Di Vella G, Arpaio A, Marzullo A, et al. Rupture of the spleen or splenic vessels (splenic emergency syndrome) in late pregnancy: a report of two autopsy cases. Forensic Sci Int. 2008;176:e1–5.CrossRefPubMedGoogle Scholar
  36. 36.
    Maymon R, Zimenman AL, Strauss S, et al. Maternal spleen size throughout normal pregnancy. Semin Ultrasound CT MRI. 2007;28:64–6.CrossRefGoogle Scholar
  37. 37.
    Barcroft J, Stevens J. The effect of pregnancy and menstruation on the size of the spleen. J Physiol. 1982;66:32–6.CrossRefGoogle Scholar
  38. 38.
    Sakhel K, Aswad N, Usta I, et al . Postpartum splenic rupture. Obstet Gynecol. 2003;102:1207–10.PubMedGoogle Scholar
  39. 39.
    Harper JA, Huertas J. Spontaneous rupture of the normal spleen during labour. Can Med Assoc J. 1950;63:169–70.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Barnett T. Rupture of the spleen in pregnancy: a review of the recorded cases with a further case report. J Obstet Gynaecol Br Emp. 1952;59:795–802.CrossRefPubMedGoogle Scholar
  41. 41.
    Barrilleaux PS, Adair D, Johnson G, Lewis D. Splenic rupture associated with severe preeclampsia. J Reprod Med. 1999;44:899–901.PubMedGoogle Scholar
  42. 42.
    McIndoe A. Delayed haemorrhage following traumatic rupture of the spleen. Br J Surg. 1932;20:249–68.CrossRefGoogle Scholar
  43. 43.
    Moore D. Rupture of the spleen in pregnancy. West J Surg Obstet Gynecol. 1956;64:306–16.PubMedGoogle Scholar
  44. 44.
    Klinkert P, Kluit AB, de Vries AC, Puylaert J. Spontaneous rupture of the spleen: role of ultrasound in diagnosis, treatment, and monitoring. Eur J Surg. 1999;165:712–3.CrossRefPubMedGoogle Scholar
  45. 45.
    Hillemanns P, Knitza R, Muller-Hocker J. Rupture of splenic artery aneurysm in a pregnant patient with portal hypertension. Am J Obstet Gynecol. 1996;174:1665–6.CrossRefPubMedGoogle Scholar
  46. 46.
    Herbeck M, Horbach T, Putzenlechner C, et al. Ruptured splenic artery aneurysm during pregnancy: a rare case with both maternal and fetal survival. Am J Obstet Gynecol. 1999;181:763–4.CrossRefPubMedGoogle Scholar
  47. 47.
    Wagner WH, Allins AD, Treiman R, et al. Ruptured visceral artery aneurysms. Ann Vasc Surg. 1997;11:342–7.CrossRefPubMedGoogle Scholar
  48. 48.
    Lang W, Strobel D, Beinder E, et al. Surgery of a splenic artery aneurysm during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2002;102:215–6.CrossRefPubMedGoogle Scholar
  49. 49.
    Puri A, Khadem P, Ahmed S. Imaging of trauma in a pregnant patient. Semin Ultrasound CT MRI. 2012;33:37–45.CrossRefGoogle Scholar
  50. 50.
    Savor R. Zentralbl Gynakol. 1898;22:1305.Google Scholar
  51. 51.
    Ochsner MG. Factors of failure for nonoperative management of blunt liver and splenic injuries. World J Surg. 2001;25:1393–6.Google Scholar
  52. 52.
    Rolton DJ, Lovegrove RE, Dehn TC. Laparoscopic splenectomy and diaphragmatic rupture repair in a 27-week pregnant trauma patient. Surg Laparosc Endosc Percutan Tech. 2009;19:e159–60.CrossRefGoogle Scholar
  53. 53.
    Latic F, Delibegovic S, Latic A, et al. Urgent laparoscopic splenectomy after traumatic splenic rupture in pregnancy. Acta Inf Med. 2009;17:231–2.Google Scholar
  54. 54.
    Firstenberg MS, Plaisier B, Newman JS, et al. Successful treatment of delayed splenic rupture with splenic artery embolisation. Surgery. 1998;123:584–6.CrossRefPubMedGoogle Scholar
  55. 55.
    Simpson I, Nq A, Griffin C. A rare cause of an acute abdomen in late pregnancy. Aust N Z J Obstet Gynaecol. 1995;35:435–6.CrossRefPubMedGoogle Scholar
  56. 56.
    Studdiford W. Primary peritoneal pregnancy. Am J Obstet Gynecol. 1942;44:487–91.CrossRefGoogle Scholar
  57. 57.
    Biolchini F, Giunta A, Bigi L, et al. Emergency laparoscopic splenectomy for haemoperitoneum because of ruptured primary splenic pregnancy: a case report and review of literature. ANZ J Surg. 2010;80:55–7.CrossRefPubMedGoogle Scholar
  58. 58.
    Zhang Y, Kang D, Zhang B, et al. Ectopic pregnancy causing splenic rupture. Am J Emerg Med. 2016;34:1184.e1–2.CrossRefGoogle Scholar
  59. 59.
    Julania S, Tai R. Heterotopic simultaneous splenic and intrauterine pregnancy after spontaneous conception and review of literature. J Obstet Gynaecol Res. 2013;39:367–70.CrossRefPubMedGoogle Scholar
  60. 60.
    Kitade M, Takeuchi H, Kikuchi I, et al. A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology. Fertil Steril. 2005;83:1042.CrossRefPubMedGoogle Scholar
  61. 61.
    Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000;61:1080–8.Google Scholar
  62. 62.
    Yagil Y, Beck-Razi N, Amit A, et al. Splenic pregnancy: the role of abdominal imaging. J Ultrasound Med. 2007;26:1629–32.CrossRefPubMedGoogle Scholar
  63. 63.
    Beaussier M. Sur un anevrisme de l’artere splenique dont les parois se sont ossifiees. J Med Chir Pharm Paris. 1770;32:157–65.Google Scholar
  64. 64.
    Parker E. Dublin J Med Sci. 1844;26:124.Google Scholar
  65. 65.
    Parker E. Edinb Med Surg J. 1844;62:132–3.Google Scholar
  66. 66.
    Crisp E, editor. A treatise on the structure, diseases and injuries of the blood-vessels. London: Churchill; 1847. 251 p.Google Scholar
  67. 67.
    Winckler V. Ein fall von milzexstirpation wegen aneurysma der arteria lienalis. Zentralbl Chir. 1905;32:257–60.Google Scholar
  68. 68.
    Corson E. Aneurysm of the splenic artery: rupture and death. Med Surg Rep. 1869;20:351.Google Scholar
  69. 69.
    Barrett JM, Van Hooydonk JE, Boehm FH. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv. 1982;37:557–66. CrossRefGoogle Scholar
  70. 70.
    Berger JS, Forsee JH, Furst J. Splenic arterial aneurysm. Ann Surg. 1953;137:108–10.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Owens JC, Coffey R. Aneurysm of the splenic artery, including a report of six additional cases. Int Abstr Surg. 1953;97:313–35.PubMedGoogle Scholar
  72. 72.
    Lowry SM, O’Dea TP, Gallagher DI, et al. Splenic artery aneurysm rupture: the seventh instance of maternal and fetal survival. Obstet Gynecol. 1986;67:291–2.CrossRefPubMedGoogle Scholar
  73. 73.
    Selo-Ojeme DO, Welch CC. Review: spontaneous rupture of splenic artery aneurysm in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2003;109:124–7.CrossRefPubMedGoogle Scholar
  74. 74.
    Sheps SG, Spittel JA Jr, Fairbairn J II, et al. Aneurysms of the splenic artery with special reference to bland aneurysms. Proc Staff Meet Mayo Clin. 1958;33:381.PubMedGoogle Scholar
  75. 75.
    De Perrot M, Buhler L, Deleaval J, et al. Management of true aneurysms of the splenic artery. Am J Surg. 1998;175:466–8.CrossRefPubMedGoogle Scholar
  76. 76.
    Messina LM, Shanley C. Visceral artery aneurysms. Surg Clin North Am. 1997;77:425–42.CrossRefPubMedGoogle Scholar
  77. 77.
    Mattar SG, Lumsden AB. The management of splenic artery aneurysms: experience with 23 cases. Am J Surg. 1995;169:580–4.CrossRefPubMedGoogle Scholar
  78. 78.
    Dhinakar M, Al Mashini S, Golash V. Rupture of splenic artery aneurysm during pregnancy: a report of two case. Oman Med J. 2011;26:e025.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Stojanovic I, Milic M, Ilic G, et al. Ruptured splenic artery aneurysm in the 35th week of pregnancy. Medical error or bad luck? Rom J Leg Med. 2013;21:5–8.CrossRefGoogle Scholar
  80. 80.
    Salo JA, Salmenkivi K, Tenhunen A, et al. Rupture of splanchnic artery aneurysms. World J Surg. 1986;10:123–7.CrossRefPubMedGoogle Scholar
  81. 81.
    Boumans D, Weerink LBM, Rheineck Leyssius A, et al. Splenic artery rupture during pregnancy concealed by a pancreatic lymphangioma: a rare co-occurrence. Ann Vasc Surg. 2013;27:112.e1–4.CrossRefGoogle Scholar
  82. 82.
    El-Shawarby SA, Franklin O, South M, et al. Caesarean splenectomy for spontaneous rupture of splenic artery aneurysm at 34 weeks gestation with survival of the mother and the preterm fetus. J Obstet Gynaecol. 2006;26:468–9.CrossRefPubMedGoogle Scholar
  83. 83.
    Gourgiotis S, Alfaras P, Salemis N. Spontaneous rupture of splenic artery aneurysm in pregnancy: a case report. Adv Med Sci. 2008;53:341–3.CrossRefPubMedGoogle Scholar
  84. 84.
    Al-Rayyan E, Maayteh M, Al-Khawaldeh M, et al. Rupture of splenic artery aneurysm during pregnancy: a report of maternal and fetal survival. Rawal Med J. 2011;36:71–7.Google Scholar
  85. 85.
    Angelakis EJ, Bair WE, Barone J, et al. Splenic artery aneurysm rupture during pregnancy. Obstet Gynecol Surv. 1993;48:145–8.CrossRefPubMedGoogle Scholar
  86. 86.
    Rahmoune FC, Aya G, Biard M, et al. Splenic artery aneurysm rupture in late pregnancy: a case report and review of the literature. Ann Fr Anesth Reanim. 2011;30:156–8.CrossRefPubMedGoogle Scholar
  87. 87.
    Vassalotti SB, Schaller JA. Spontaneous rupture of splenic artery aneurysm in pregnancy. Report of first known antepartum rupture with maternal and fetal survival. Obstet Gynecol. 1967;30:264–8.Google Scholar
  88. 88.
    Abbas MA, Stone WM, Fowl RJ, et al. Splenic artery aneurysms: two decades experience at Mayo Clinic. Ann Vasc Surg. 2002;16:442–9.CrossRefGoogle Scholar
  89. 89.
    Anderson W, Gray J. Report of a case of aneurysm of the splenic artery: with references to 58 cases collected by the authors. Br J Surg. 1929;17:267–77.CrossRefGoogle Scholar
  90. 90.
    Machemer WL, Fuge W. Aneurysm of the splenic artery: report of a case and review of the literature. Arch Surg. 1939;39:190–204.CrossRefGoogle Scholar
  91. 91.
    Sherlock SPV, Learmonth J. Aneurysm of the splenic artery; with an account of an example complicating Gaucher’s disease. Br J Surg. 1942;30:151–60.CrossRefGoogle Scholar
  92. 92.
    Bedford PD, Lodge B. Aneurysm of the splenic artery. Gut. 1960;1:312–20.CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Khurana J, Spinello IM. Splenic artery aneurysm rupture: a rare but fatal cause for peripartum collapse. J Intensive Care Med. 2013;28:131–3.CrossRefPubMedGoogle Scholar
  94. 94.
    Stanely JC, Fry W. Pathogenesis and clinical significance of splenic artery aneurysm. Surgery. 1974;76:889–909.Google Scholar
  95. 95.
    Holdsworth RJ, Gunn A. Ruptured splenic artery aneurysm in pregnancy. A review. BJOG. 1992;99:595–7.CrossRefGoogle Scholar
  96. 96.
    de Vries JE, Schattenkerk ME, Malt RA. Complications of splenic artery aneurysm other than intraperitoneal rupture. Surgery. 1982;91:200–4.Google Scholar
  97. 97.
    O’Grady JP, Day EJ, Toole AL, et al. Splenic artery aneurysm rupture in pregnancy. A review and case report. Obstet Gynecol. 1977;50:627–30.PubMedGoogle Scholar
  98. 98.
    Trastek VF, Pairolero PC, Joyce J, et al. Splenic artery aneurysms. Surgery. 1982;91:694–9.PubMedGoogle Scholar
  99. 99.
    Arabia R, Pellicano S, Siciliani R, et al. Splenic artery aneurysm and portal hypertension. Report of a case. Minerva Med. 1999;90:143–5.PubMedGoogle Scholar
  100. 100.
    Dave SP, Reis ED, Hossain A, et al. Splenic artery aneurysm in the 1990s. Ann Vasc Surg. 2000;14:223–9.CrossRefPubMedGoogle Scholar
  101. 101.
    English JD. Spontaneous rupture of a splenic artery aneurysm in the third trimester. Ir J Med Sci. 1993;162:169–70.CrossRefPubMedGoogle Scholar
  102. 102.
    Caillouette JC, Merchant E. Ruptured splenic artery aneurysm in pregnancy. Twelfth reported case with maternal and fetal survival. Am J Obstet Gynecol. 1993;168:1810–3.CrossRefPubMedGoogle Scholar
  103. 103.
    Abad C, Montesdeoca-Cabrera D, Saez-Guzman T. Review of two surgically operated cases. An Med Interna. 2006;23:130–2.PubMedGoogle Scholar
  104. 104.
    Al-Habbal Y, Christophi C, Muralidharan V. Aneurysms of the splenic artery: a review. Surgeon. 2010;8:223–31.CrossRefPubMedGoogle Scholar
  105. 105.
    Stanley JC, Fry WJ. Pathogenesis and clinical significance of splenic artery aneurysms. Surgery. 1974;76:898–909.Google Scholar
  106. 106.
    Pyrah LN, Stansfield FR, Garland H. Hemoperitoneum due to spontaneous rupture of the splenic vein. BMJ. 1929;1:810.Google Scholar
  107. 107.
    Baird M. Ruptures of a splenic artery aneurysm in pregnancy. Proc R Soc Med. 1973;66:762–3.PubMedPubMedCentralGoogle Scholar
  108. 108.
    Shepard D, Foster C. Spontaneous rupture of the splenic vein during pregnancy. Ann Surg. 1961;153:1029–32.CrossRefPubMedPubMedCentralGoogle Scholar
  109. 109.
    Chaichian S, Mehdizadeh A, Akbarian A, et al. Rupture of splenic artery aneurysm with portal hypertension during pregnancy: a case report. J Obstet Gynaecol Can. 2006;28:303–4.CrossRefPubMedGoogle Scholar
  110. 110.
    Barrett JM, Caldwell BH. Association of portal hypertension and ruptured splenic artery aneurysm in pregnancy. Obstet Gynecol. 1981;57:255–7.Google Scholar
  111. 111.
    Czekelius P, Deichert L, Gesenhues T, et al. Rupture of an aneurysm of the splenic artery and pregnancy: a case report. Eur J Obstet Gynecol Reprod Biol. 1991;38:229–32.CrossRefPubMedGoogle Scholar
  112. 112.
    Toes N. Ruptured splenic arterial aneurysm during parturition. BMJ. 1956;1:495.CrossRefPubMedGoogle Scholar
  113. 113.
    Parangi S, Levine D, Henry A, et al. Surgical gastrointestinal disorders during pregnancy. Am J Surg. 2007;193:223–32.CrossRefPubMedGoogle Scholar
  114. 114.
    Groussolles M Jr, Merveille M, Alacoque X, et al. Rupture of a splenic artery aneurysm in the first trimester of pregnancy. J Emerg Med. 2011;41:e13–6.CrossRefPubMedGoogle Scholar
  115. 115.
    Chookun J, Bounes V, Ducassé JL, et al. Rupture of splenic artery aneurysm during early pregnancy: a rare and catastrophic event. Am J Emerg Med. 2009;27:e5–6.CrossRefGoogle Scholar
  116. 116.
    Veschambre P, Coppo B, Grosieux P. Rupture of aneurysm of the splenic artery during the first three months of pregnancy. Presse Med. 1993;22:1693–4.PubMedGoogle Scholar
  117. 117.
    Pavlis T, Seretis C, Gourgiotis S, et al. Spontaneous rupture of splenic artery aneurysm during the first trimester of pregnancy: report of an extremely rare case and review of the literature. Case Rep Obstet Gynecol. 2012;2012:528051.PubMedPubMedCentralGoogle Scholar
  118. 118.
    Sadat U, Dar O, Walsh S, et al. Splenic artery aneurysms in pregnancy—a systematic review. Int J Surg. 2008;6:261–5.CrossRefPubMedGoogle Scholar
  119. 119.
    Kunz MN, Pantalone D, Borri A, et al. Management of true splenic artery aneurysms. Two case reports and review of the literature. Minerva Chir. 2003;58:247–56.Google Scholar
  120. 120.
    Macfarlane JR, Thorbjarnarson B. Rupture of splenic artery aneurysm during pregnancy. Am J Obstet Gynecol. 1966;95:1025–37.CrossRefPubMedGoogle Scholar
  121. 121.
    Lelong DC, Logak M. Pathogenesis of spontaneous cervico-cerebral artery dissection. A hypothesis and a review of the literature. Med Hypotheses. 2004;62:453–7.CrossRefPubMedGoogle Scholar
  122. 122.
    Al Asfar F, Saber M, Dhar PM, et al. Rupture of splenic artery aneurysm during labor: a case report of maternal and fetal survival. Med Princ Pract. 2005;14:53–4.CrossRefPubMedGoogle Scholar
  123. 123.
    Pasternack JG, Shaw J. New Orleans Med Surg J. 1939;92:94–8.Google Scholar
  124. 124.
    Richardson AJ, Bahlool S, Knight J. Ruptured splenic artery aneurysm in pregnancy presenting in a manner similar to pulmonary embolus. Anaesthesia. 2006;61:187–9.CrossRefPubMedGoogle Scholar
  125. 125.
    Tsokos M, Nolting R-O, Lockemann U. Sudden, unexpected death due to splenic artery aneurysm rupture. Am J Forensic Med Pathol. 2005;26:83–5.CrossRefPubMedGoogle Scholar
  126. 126.
    Högler F. Beitrag zur klinik des leber und milzarterien aneurysmas. Wien Arch Inn Med. 1920;1:508.Google Scholar
  127. 127.
    Lindboe E. Aneurysm of the splenic artery diagnosed by X-rays and operated on with success. Acta Chir Scand. 1932;72:108–14.Google Scholar
  128. 128.
    Ishida H, Konno K, Hamashima Y, et al. Splenic artery aneurysm: value of color Doppler and the limitation of gray-scale ultrasonography. Abdom Imaging. 1998;23:627–32.CrossRefPubMedGoogle Scholar
  129. 129.
    Pilleul F, Beuf O. Diagnosis of splanchnic artery aneurysms and pseudoaneurysms, with special reference to contrast enhanced 3D magnetic resonance angiography: a review. Acta Radiol. 2004;45:702–8.CrossRefPubMedGoogle Scholar
  130. 130.
    Abu-Khalaf MM, Al-Ameer SM, Smadi M, et al. Intrasplenic arterial aneurysms during pregnancy. Case Rep Obstet Gynecol. 2015;2015:248141.CrossRefGoogle Scholar
  131. 131.
    Barišić T, Šutalo N, Letica L, et al. Rupture of splenic artery aneurysm in primipara five days after cesarean section: case report and review of the literature. Wien Klin Wochenschr. 2015;127:896–8.CrossRefPubMedGoogle Scholar
  132. 132.
    Puttini M, Aseni P, Brambilla G, et al. Splenic artery aneurysms in portal hypertension. J Cardiovasc Surg (Torino). 1982;23:490–3.Google Scholar
  133. 133.
    Piffaretti G, Tozzi M, Lomazzi C, et al. Splenic artery aneurysms: postembolization syndrome and surgical complications. Am J Surg. 2007;193:166–70.CrossRefPubMedGoogle Scholar
  134. 134.
    Cosgrove GE, Watts JC, Kaump D. Spontaneous rupture of splenic arterial aneurysms. Am J Clin Pathol. 1947;17:372–82.CrossRefPubMedGoogle Scholar
  135. 135.
    Poidevin L. Rupture of the splenic artery aneurysm in pregnancy. Med J Aust. 1955;1:922–3.Google Scholar
  136. 136.
    Lau G. Are maternal deaths on the ascent in Singapore? A review of maternal mortality reflected by coronial casework from 1990–1999. Ann Acad Med Singapore. 2002;31:261–75.PubMedGoogle Scholar
  137. 137.
    Prahlow JA, Barnard JJ. Pregnancy-related maternal deaths. Am J Forensic Med Pathol. 2004;25:220–36.CrossRefPubMedGoogle Scholar
  138. 138.
    Shahabi S, Jani J, Masters L, et al. Spontaneous rupture of a splenic artery aneurysm in pregnancy: report of two cases. Acta Chir Belg. 2000;5:231–3.Google Scholar
  139. 139.
    Reches A, Almog R, Pauzner D, et al. Spontaneous splenic rupture in pregnancy after heparin treatment. BJOG. 2005;112:837–8.CrossRefPubMedGoogle Scholar
  140. 140.
    Hunsaker DM, Turner S, Hunsaker J. Sudden and unexpected death resulting from splenic artery aneurysm rupture: two case reports of pregnancy related fatal rupture of splenic artery aneurysm. Am J Forensic Med Pathol. 2002;23:338–41.CrossRefPubMedGoogle Scholar
  141. 141.
    Lowenthal M, Jacob H. Aneurysm of splenic vein—report of a case. Acta Med Orient. 1953;12:170–4.Google Scholar
  142. 142.
    Parpaglioni R, Metta E, Zagari A, et al. Spontaneous splenic vein aneurysm rupture in the puerperium. Int J Obstet Anesth. 2009;18:48–51.CrossRefPubMedGoogle Scholar
  143. 143.
    Eckerling B, Goldman JA, Yado S. Spontaneous rupture of the splenic vein in pregnancy with massive retro- and intraperitoneal hemorrhage. Am J Surg. 1962;103:636–9.CrossRefGoogle Scholar
  144. 144.
    Rahn J, Steffen F. Splenic vein rupture during pregnancy following acute pancreatic necrosis. Zentralbl Gynakol. 1959;81:1823–30.PubMedGoogle Scholar
  145. 145.
    Turan N, Oghan F, Boran T. Spontaneous rupture of splenic vein in a pregnant woman during a religious ritual. J Forensic Legal Med. 2007;14:440–3.CrossRefGoogle Scholar
  146. 146.
    Madhavan P, Hegarty P, Akram M, Drumm J. Spontaneous rupture of the splenic vein in pregnancy. Ir Med J. 1998;91:64.PubMedGoogle Scholar
  147. 147.
    Wheelock J. Spontaneous splenic vein rupture in pregnancy: case report. Mil Med. 1982;147:64.CrossRefPubMedGoogle Scholar
  148. 148.
    Puder H. Thrombosis and rupture of the splenic vein in “acute obstetrical hypercoagulamic syndrome”. Zentralbl Gynakol. 1961;83:1370–5.PubMedGoogle Scholar
  149. 149.
    Newman B, Gaal GZ, Jackson E. Spontaneous rupture of the splenic vein during pregnancy. South Med J. 1963;56:11–3.CrossRefPubMedGoogle Scholar
  150. 150.
    Friebel H. Rupture of the splenic vein and pancreatic necrosis in pregnancy. Zentralbl Gynakol. 1962;84:137–45.PubMedGoogle Scholar
  151. 151.
    Safioleas MC, Moulakakis KG. A rare cause of intra-abdominal haemorrhage: spontaneous rupture of the splenic vein. Acta Chir Belg. 2006;106:237–9.CrossRefPubMedGoogle Scholar
  152. 152.
    Tolgonay G, Ozbek SS, Oniz H, et al. Regression of splenic vein aneurysm following resolution of splenomegaly. J Clin Ultrasound. 1998;26:98–102.CrossRefPubMedGoogle Scholar
  153. 153.
    Shirohara H, Endo M, Sakai K, et al. Enlarging splenic vein aneurysm associated with stagnation of splenic venous blood flow. Am J Gastroenterol. 1996;91:385–7.PubMedGoogle Scholar
  154. 154.
    Shimoda M, Kubota K, Sakuma A, et al. Intra-abdominal hemorrhage due to rupture of a splenic vein aneurysm: a case report. J Gastrointest Surg. 2003;7:683–6.CrossRefPubMedGoogle Scholar
  155. 155.
    Torres G, Hines GL, Monteleone F, et al. Splenic vein aneurysm: is it a surgical indication? J Vasc Surg. 1999;29:719–21.CrossRefPubMedGoogle Scholar
  156. 156.
    Régent D, Hodez C, Bigard M, et al. Splenic arterial aneurysm rupturing into the splenic vein. A rare cause of acute portal hypertension in the postpartum period. J Radiol Electrol Med Nucl. 1977;58:151–4.PubMedGoogle Scholar
  157. 157.
    Aggarwal N, Negi N, Aggarwal A, Bodh V, Dhiman RK. Pregnancy with portal hypertension. J Clin Exp Hepatol. 2014;4:163–71.CrossRefPubMedPubMedCentralGoogle Scholar
  158. 158.
    Mata KM, Li W, Reslan OM, et al. Adaptive increases in expression and vasodilator activity of estrogen receptor subtypes in a blood vessel-specific pattern during pregnancy. Am J Physiol Heart Circ Physiol. 2015;309:H1679–96.CrossRefPubMedPubMedCentralGoogle Scholar
  159. 159.
    Riva HL, Pickhardt WL, Breen J. Rupture of splenic artery aneurysm in pregnancy; report of a case. Obstet Gynecol. 1957;10:569–72.PubMedGoogle Scholar
  160. 160.
    Tomsykoski AJ, Stevens RC, Izzo PA, et al. Aneurysm of the splenic artery in pregnancy. Am J Obstet Gynecol. 1953;66:1264–70.CrossRefPubMedGoogle Scholar
  161. 161.
    Gillam M. Ruptured aneurysm of splenic artery during pregnancy. BMJ. 1942;1:69–70.CrossRefPubMedGoogle Scholar
  162. 162.
    Meek H. Dislocated spleen with torsion of pedicle complicating pregnancy: removal of spleen: delivery at term. BMJ. 1907;1:928.CrossRefPubMedGoogle Scholar
  163. 163.
    Huang YH, Hsu CY, Chang YF, et al. Postcesarean splenic torsion. Taiwan J Obstet Gynecol. 2006;45:257–9.CrossRefPubMedGoogle Scholar
  164. 164.
    Parvaiz A, Chandran S, Karim A, et al. Torted and ruptured wandering spleen presenting as a surgical emergency in pregnancy. ScientificWorldJournal. 2004;4:1035–7.CrossRefPubMedPubMedCentralGoogle Scholar
  165. 165.
    Lahiri S, Dasgupta N, Mondal A. A case of splenic torsion and rupture presenting as ruptured ectopic pregnancy. J Surg Case Rep. 2010;2010:4.PubMedPubMedCentralGoogle Scholar
  166. 166.
    Alimoglu O, Sahin M, Akleg M. Torsion of a wandering spleen presenting with acute abdomen a case report. Acta Chir Belg. 2004;104:221–3.CrossRefPubMedGoogle Scholar
  167. 167.
    Swischuk LE, Williams JB, John S. Torsion of a wandering spleen: the whorled appearance of the splenic pedicle on CT. Pediatr Radiol. 1993;23:476–7.CrossRefPubMedGoogle Scholar
  168. 168.
    Gilman RS, Thomas RL. Wandering spleen presenting as acute pancreatitis in pregnancy. Obstet Gynecol. 2003;101:1100–2.PubMedGoogle Scholar
  169. 169.
    Akinola O, Fabamwo A, Rabiu K, et al. Splenic torsion in pregnancy: a case report. Int J Trop Med. 2009;4:129–31.Google Scholar
  170. 170.
    Karantanas AH, Stagianis K. The value of MR angiography in predicting the risk of torsion of a pelvic spleen during pregnancy. Eur Radiol. 2002;12:309–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Goran Augustin
    • 1
    • 2
  1. 1.School of Medicine University of ZagrebZagrebCroatia
  2. 2.Department of SurgeryUniversity Hospital Centre ZagrebZagrebCroatia

Personalised recommendations