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.Tkachenko L.V., Verovskaya T.A., Skladanovskaya T.V., Sviridova N.I., Serdyukov S.V.
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.
Keywords
spleen
spontaneous splenic rupture
spontaneous splenic rupture and pregnancy
References
- Михайлин Е.С., Иванова Л.А., Савицкий А.Г., Кучерявый С.Г., Краснолобов Р.А., Краснолобова П.Ю. Случай спонтанного разрыва селезенки во время беременности. Журнал акушерства и женских болезней. 2014; 63(4): 69-73. [Mikhailin E.S., Ivanova L.A., Savitsky A.G., Kucheryavyy S.G., Krasnolobov R.A., Krasnolobova P.Yu. A case of spontaneous rupture of the spleen during pregnancy. Journal of Obstetrics and Woman Diseases. 2014; 63(4): 69-73. (in Russian)]. https://dx.doi.org/10.17816/JOWD63469-73.
- Пиголкин Ю.И., Должанский О.В., Пальцева Е.М., Шилова М.А., Федоров Д.Н., Боева С.Е. Судебно-медицинская оценка травматических и спонтанных разрывов органов при поражении опухолью. Судебно-медицинская экспертиза. 2017; 2: 49-56. [Pigolkin Yu.I., Dolzhansky O.V., Paltseva E.M., Shilova M.A., Fedorov D.N., Boeva S.E. Forensic medical assessment of traumatic and spontaneous ruptures of organs in case of tumor damage. Forensic medical examination. 2017; 2: 49-56. (in Russian)].
- Богомолов Д.В., Должанский О.В. Геморрагическая псевдокиста поджелудочной железы со спонтанным разрывом селезенки. Архив патологии. 2002; 64(4): 44-5. [Bogomolov D.V., Dolzhanskiy O.V. Hemorrhagic pseudocyst of the pancreas with spontaneous rupture of the spleen. Archive of Pathology. 2002; 64(4): 44-5. (in Russian)].
- Геллер А.Н., Геллер С.И. О спонтанных разрывах селезенки. Клиническая хирургия. 1973; 11: 79-80. [Geller A.N., Geller S.I. On spontaneous ruptures of the spleen. Clinical surgery. 1973; 11: 79-80. (in Russian)].
- Усов Д.В., Махнев В.А., Белова З.И. Лечение закрытых повреждений селезенки. Вестник хирургии им. И.И. Грекова. 1983; 2: 74-7. [Usov D.V., Makhnev V.A., Belova Z.I. Treatment of closed injuries of the spleen. Bulletin of surgery named after I.I. Grekov. 1983; 2: 74-7. (in Russian)].
- Crate I.D., Payne M.J. Is the diagnosis of spontaneous rupture of a normal spleen valid? J. R. Army Med. Corps. 1991; 137(1): 50-1. https://dx.doi.org/10.1136/jramc-137-01-12.
- Ballardini P., Incasa E., Del Noce A., Cavazzini L., Martoni A., Piana E. Spontaneous splenic rupture after the start of lung cancer chemotherapy. A case report. Tumori. 2004; 90(1): 144-6.
- Kyriacou A., Arulraj N., Varia H. Acute abdomen due to spontaneous splenic rupture as the first presentation of lung malignancy: a case report. J. Med. Case Rep. 2011; 5: 444. https://dx.doi.org/10.1186/1752-1947-5-444.
- Доброхотова Ю.Э., Сулима А.Н., Пучкина Г.А. Оценка риска развития спаечного процесса после оперативных вмешательств на органах репродуктивной системы. Акушерство и гинекология. 2020; 7: 105-10. [Dobrokhotova Yu.E, Sulima A.N., Puchkina G.A. Assessment of the risk of developing adhesions after surgical interventions on the organs of the reproductive system. Obstetrics and Gynecology. 2020; 7: 105-10. https://dx.doi.org/10.18565/aig.2020.7.105-110. (in Russian)].
Received 08.09.2021
Accepted 30.12.2021
About the Authors
Lyudmila V. Тkachenko, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University, Ministry of Health of the Russian Federation, +7(905)063-10-72, tkachenko.fuv@maill.ru,400066, Russia, Volgograd, Square of the Fallen Fighters, 1.
Tatyana A. Verovskaya, Head Freelance Obstetrician Gynecologist of the Health Committee of the Volgograd Region,
Chief Physician of the Volgograd Regional Clinical Perinatal Center No. 2, +7(902)314-44-83, verovskayata@mail.ru, 400062, Russia, Volgograd, Marshal Vasilevsky str., 70.
Tatyana V. Skladanovskaya, PhD, Associate Professor, Department of Obstetrics and Gynecology, Institute of Continuous Medical and Pharmaceutical Faculty, Volgograd State Medical University, Ministry of Health of the Russian Federation, +7(902)385-32-05, Yanechka2000@yandex.ru, 400066, Russia, Volgograd, Square of the Fallen Fighters, 1.
Natalia I. Sviridova, Dr. Med. Sci., Professor of the Department of Obstetrics and Gynecology, Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Ministry of Health of the Russian Federation, +7(906)409-03-43, n.i.sviridova@yandex.ru, 400066, Russia, Volgograd, Square of the Fallen Fighters, 1.
Sergey V. Serdykov, PhD, Associate Professor of the Department of Obstetrics and Gynecology, Volgograd State Medical University, Ministry of Health of the Russian Federation, +7(904)770-95-71, ssv-414.001@mail.ru, 400066, Russia, Volgograd, Square of the Fallen Fighters, 1.
Authors’ contributions: Tkachenko L.V., Verovskaya T.A., Skladanovskaya T.V., Sviridova N.I., Serdyukov S.V. – concept and design of the investigation; data collection; information analysis and systematization; writing and editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest, which are to be informed.
Funging: The investigation has not been sponsored.
Ethical approval: The study was reviewed and approved by the Research Ethics Committee of the Volgograd State Medical University, Ministry of Health of the Russian Federation (Ref. No: 025/04.02.2022).
Patients’ Consent for Publication: The patient has signed an informed consent form to publish her data.
For citation: Tkachenko L.V., Verovskaya T.A., Skladanovskaya T.V., Sviridova N.I., Serdyukov S.V. Splenic rupture during pregnancy: casuistics or a cause-and-effect relation.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 2: 120-124 (in Russian)
https://dx.doi.org/10.18565/aig.2022.2.120-124
