Splenic rupture during pregnancy: casuistics or a cause-and-effect relation

Background: Splenic rupture during pregnancy is a rare and potentially fatal condition. Data from multiple reviews demonstrate the rarer occurrence of spontaneous splenic rupture. The definition of spontaneous rupture is conditional, because during the latter it is often possible to establish a minor injury that in the presence of the intact splenic parenchyma could not lead to disintegration of the organ. The paper describes cases of spontaneous splenic rupture in pregnant women with liver cancer, pancreatic cancer, or Gaucher’s disease. The number of publications on the problem of spontaneous splenic rupture in pregnant women is limited in both Russian and foreign literature. In connection with the above, this case is of particular interest. Case report: The paper presents the authors’ own case of splenic rupture in a puerpera on the first day after timely delivery. The patient was admitted to the maternity hospital for regular labor activity. Delivery per vias naturalis occurred. By the end of the first day of the postpartum period there were clinical signs of massive intra-abdominal bleeding. Revising the abdominal organs detected splenic rupture; splenectomy was performed. Conclusion: This clinical observation belongs to a near miss case and only a multidisciplinary approach and careful monitoring of the patient have allowed fatal consequences to be avoided.

spleen, spontaneous splenic rupture, spontaneous splenic rupture and pregnancy