Splenic artery aneurysm rupture during pregnancy: A report of two cases

One of the most common aneurysms in the abdomen is the splenic artery aneurysm (SAA). Ruptured SAAs have a significant morbidity and mortality risk, especially for pregnant women and, consequently, for fetuses. The first patient was a twenty-eight-year-old female who, during the 30th week of pregnancy, underwent an urgent cesarean section. Postoperatively, on the 7th day, she developed severe abdominal pain. After the rapid deterioration, imaging revealed SAA rupture, and she underwent an explorative laparotomy and splenectomy. The second patient is thirty-two years old and has had non-cirrhotic portal vein hypertension since the age of 10. During her 28th week of pregnancy, she was admitted to the emergency department with complaints of severe abdominal pain and vomiting, consequently hemorrhagic shock. The imaging revealed massive intraperitoneal fluid and the SAA rupture. She underwent an emergency laparotomy, splenectomy, and cesarean section. Uncommon but has a significant mortality rate for both mother and fetus, and rupture must be considered for any pregnant woman with sudden abdominal pain and hemodynamic instability. Prompt evaluation and intervention are critical for both fetal and maternal morbidity and mortality.