Nontraumatic spontaneous splenic rupture in the third trimester of pregnancy: a case report

Öz

Spontaneous splenic rupture in pregnancy is a rare but life-threatening complication requiring urgent surgical intervention. If it remains unrecognized, it can be fatal for both mother and baby. Herein, we present a case of spontaneous rupture of a normal spleen at 28.4 weeks gestation. Early diagnosis and aggressive surgical intervention can provide maternal and fetal survival. In case of a suspected splenic rupture, urgent exploratory laparotomy via a midline vertical incision to allow visualization of and access to bleeding location should be performed to save mother’s and baby’s lives.

 Key words: Pregnancy, rupture spontaneous, spleen

Gebeliğin üçüncü üç aylık döneminde kendiliğinde gelişen dalak rüptürü: vaka sunumu

Öz

Kendiliğinden dalak rüptürü gebelikte nadir gözlenir fakat acil cerrahi müdahale gerektiren yaşamı tehdit eden bir komplikasyondur.  Bu makalede 28,4 haftalık gebede kendiliğinden gelişen dalak rüptürü vakası sunulmuştur. Erken tanı ve hızlı cerrahi müdahale anne ve bebeğin hayatını kurtarılabilir. Dalak rüptüründe şüphelenildiği zaman, bebek ve anne hayatı için acil eksploratif laparatomi - kanama yerini görebilmek ve ulaşmak için karın orta hat kesi ile yapılan - yapılması gerekir.

 Anahtar Kelimeler: Gebelik, kendiliğinden rüptür, dalak

               

Anahtar Kelimeler

• Gebelik, kendiliğinden rüptür, dalak

Kaynakça

1. Hoffman RL. Rupture of the spleen. A review and report of a case following abdominal hysterectomy. Am J Obstet Gynecol 1972; 113: 524-30.
2. Saxtorph M. Cited by Schwing C. Ruptur der Milz waehrend der Schwaenger schaft Ruptur. Zbl Gynaekol 1980; 4: 291.
3. Orloff MJ, Peskin GW. Spontaneous rupture of the normal spleen; a surgical enigma. Int Abstr Surg 1958; 106: 1-11.
4. Furler IK, Robertson DNS. Spontaneous rupture of the splenic artery in pregnancy. Lancet 1962; 2: 588-90.
5. Epstein M, King R, Kenney D. Splenic rupture at term. Case report. Missouri Med 1983; 80:83-4.
6. Di Vella G, Arpaio A, Marzullo A, Colonna M. Rupture of the spleen or splenic vessels (splenic emergency syndrome) in late pregnancy: a report of two autopsy cases. Forensic Sci Int 2008; 176: 1-5.
7. Bljajic D, Ivanisevic M, Djelmis J, Majerovic M, Starcevic V. Splenic rupture in pregnancy - traumatic or spontaneos event? Eur J Obstet Gynecol Reprod Biol 2004; 115: 113-4.
8. Sakhel K, Aswad N, Usta I, Nassar A. Postpartum splenic rupture. Obstet Gynecol 2003; 102: 1207-10.

9. Lubner M, Menias C, Rucker C, et al. Blood in the belly: CT findings of hemoperitoneum. Radiographics 2007; 27:109-25.
10. Wang C, Tu X, Li S, Luo G, Norwitz ER. Spontaneous rupture of the spleen: a rare but serious case of acute abdominal pain in pregnancy. J Emerg Med 2011; 41: 503-6.
11. de Graaff J, Pijpers PM. Spontaneous rupture of the spleen in third trimester of pregnancy. Report of a case and review of the literature. Eur J Obstet Gynecol Reprod Biol 1987; 25: 243-7.