A rare cause of maternal and fetal mortality by rupture of splenic artery aneurysm – A case report

A 26 year old pregnant female was brought unresponsive to the hospital with alleged history of loss of consciousness following giddiness. On examination, pulse was not palpable and blood pressure was not recordable. Inspite of all the resuscitative measures, she could not be revived. Fetal bradycardia was detected with doppler and emergency perimortem Caesarean Section was done. But the fetus was still born. At the autopsy of the mother, spleen was found to be enlarged with multiple areas of hemorrhage. The splenic artery was seen to be tortuous and showed an area of aneurysmal dilatation and rupture, 3cm proximal to hilum with surrounding peri-pancreatic hematoma. Peritoneal cavity contained one litre of fluid blood with blood clots in the lesser sac. Histopathological examination revealed arterio-venous malformation in the spleen with large areas of haemorrhage. Splenic artery aneurysm is a rare clinical entity that carries the risk of rupture and fatal hemorrhage. Ruptured splenic artery aneurysm can be disastrous for both the mother and fetus.