- 作者：Chenhong Wang&lowast ; ; ; ; Xinzhi Tu&lowast ; ; Shengli Li&dagger ; ; Guoyang Luo&Dagger ; ; Errol R. Norwitz§ ;
- 关键词：spleen ; rupture ; abdomen ; acute pain ; pregnancy
- 刊名：Journal of Emergency Medicine
- 出版年：2011
- 出版时间：November 2011
- 年：2011
- 卷：41
- 期：5
- 页码：503-506
- 全文大小：431 K
Background
Spontaneous (non-traumatic) rupture of the spleen rarely occurs in the setting of a normal spleen, especially during pregnancy.Objectives
We report a case of spontaneous rupture of a normal spleen at 33.7 weeks gestation and review the literature with the aim of exploring the etiology, diagnosis, and management of this condition during pregnancy.
Case Report
A 30-year-old Chinese primigravida presented at 33.7 weeks gestation with acute onset of severe, constant left upper abdominal pain. She developed acute hypotension. Physical examination revealed diffuse abdominal tenderness with rebounding and guarding. An emergent cesarean delivery and abdominal exploration was performed. A non-viable male infant was delivered, and active bleeding was identified at the splenic hilum consistent with splenic rupture. A splenectomy was performed, and a consumptive coagulopathy was identified and treated. The patient had an uncomplicated postoperative course and was discharged home on postoperative day 15.
Conclusion
Splenic rupture in pregnancy is a life-threatening complication. Early diagnosis and aggressive surgical intervention will allow for optimal maternal and perinatal outcome.