Spontaneous Splenic Vein Rupture with Massive Hemoperitoneum during the Third Trimester of Pregnancy

Marchi L^1*, Cavaliere AF¹, Garraffo C¹, Gardelli M¹, Vicini I¹, Giorgi L¹, Nardi V¹, Feroci F², Martini R³, Florio PM⁴, Spinelli G^1
1Obstetrics and Gynaecology Unit, Santo Stefano Hospital, AUSL Toscana Centro, Prato, Italy
²Surgery Unit, Santo Stefano Hospital, AUSL Toscana Centro, Prato, Italy
³Hematology Unit, Santo Stefano Hospital, AUSL Toscana Centro, Prato, Italy
⁴Obstetrics and Gynaecology Unit, San Iacopo Hospital, AUSL Toscana Centro, Pistoia, Italy

Corresponding Author: Laura Marchi, MD ^{ORCID iD}
Address: Obstetrics and Gynaecology Unit, Santo Stefano Hospital, AUSL Toscana Centro, via Suor Niccolina Infermiera 20/22, Prato, Italy.
Received date: 20 November 2020; Accepted date: 19 December 2020; Published date: 28 December 2020

Citation: Marchi L, Cavaliere AF, Garraffo C, Gardelli M, Vicini I, Giorgi L, Nardi V, Feroci F, Martini R, Florio PM, Spinelli G. Spontaneous Splenic Vein Rupture with Massive Hemoperitoneum during the Third Trimester of Pregnancy. Asp Biomed Clin Case Rep. 2020 Dec 28;4(1):1-5.

Copyright © 2021 Marchi L, Cavaliere AF, Garraffo C, Gardelli M, Vicini I, Giorgi L, Nardi V, Feroci F, Martini R, Florio PM, Spinelli G. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Pregnancy, Hemoperitoneum, Splenic Vein, Follow-up Investigations

Abstract

We describe a case of spontaneous rupture of the splenic vein in a pregnant patient at 33 weeks gestation. For the first time in literature, we report follow-up investigations aimed at understanding the cause of the event.
The woman was admitted to the emergency ward for hypovolemic shock. Maternal and fetal distress prompted an immediate cesarean section. The fetus was delivered stillborn, hemoperitoneum was present and two spontaneous splenic vein’s lacerations were found to be the source of the bleeding. The immediate splenectomy and aggressive correction of anemia and coagulopathy determined maternal survival. During the follow-up, no evidence of neither congenital nor acquired causative factors for a splenic vein rupture was found.
The aim of reporting this case is to increase the awareness between clinicians of this condition since it is both rare and with an aspecific clinical picture. It presents itself in apparently low-risk patients and a good maternal-fetal outcome can only be achieved by early diagnosis and prompt treatment.