Catastrophic Haemorhage: A Case Report on Spontaneous Rupture of Splenic Hemangioma in Pregnancy

Abstract

Spontaneous splenic rupture in pregnancy is an uncommon event in the absence of trauma. Since the diagnosis is indirect, the treatment is often delayed. In this report, we highlighted the case of a twenty-six years old Chinese, a primigravida at 28 weeks gestation who presented with hypovolemic shock preceded by vague abdominal discomfort at home. Both physical and sonographic examination revealed massive hemoperitoneum with intrauterine death most likely due to splenic rupture. The surgery done was emergency laparotomy and hysterotomy with abdominal exploration. Intraoperatively, active bleeding was identified at the lateral pole of the spleen consistent with splenic rupture. Through this report, we attempt to illustrate the importance of immediate recognition of this surgical emergency to prevent catastrophic outcome.