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Laparoscopic aneurysm resection and splenectomy for splenic artery aneurysm in the third trimester of pregnancy

机译：妊娠中期腹腔镜脾切除和脾切除术治疗脾动脉瘤

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Background: Splenic artery aneurysms (SAA) are a rare entity most commonly diagnosed incidentally. Their association with pregnancy increases the risk of rupture resulting in a disproportionately high maternal and fetal mortality. Accordingly, elective surgical treatment is recommended in asymptomatic patients with aneurysms less than 2 cm. In this case, we present a patient during her third trimester of pregnancy with a SAA who was treated by laparoscopic aneurysm resection and splenectomy. Methods: The patient is a 38-year-old multiparous woman, with an incidental diagnosis of a SAA in 2010. Subsequently, the patient became pregnant and at 27 weeks started to develop abdominal pain. Failed embolization was attempted with worsening of the patient's symptoms. A CT angiogram revealed a 1.6 cm distal third SAA without any evidence of rupture. Due to the localization of the lesion, the patient was offered a laparoscopic aneurysm resection and splenectomy. Results: Operating time was 90 min and estimated blood loss was 5 cc. Postoperative fetal monitoring was normal. No perioperative complications were observed. The patient was discharged on postoperative day 3. Two months after laparoscopic splenectomy, the patient delivered a male infant in perfect health. Conclusions: Although this is a rare disease, the risk of aneurysmal rupture is increased during pregnancy. As a result of high maternal and fetal mortality, elective surgery should be performed. Laparoscopic surgery is the technique of choice.
机译：背景：脾动脉瘤（SAA）是一种罕见的实体，最常被偶然诊断出来。它们与怀孕的关系增加了破裂的风险，导致产妇和胎儿的死亡率过高。因此，对于动脉瘤小于2 cm的无症状患者，建议选择手术治疗。在这种情况下，我们为一名患者在妊娠晚期提供了SAA，并通过腹腔镜动脉瘤切除术和脾切除术对其进行了治疗。方法：该患者为38岁的多胎女性，2010年偶然诊断出SAA。随后，该患者怀孕并在27周时开始出现腹痛。尝试失败的栓塞治疗使患者的症状恶化。 CT血管造影显示远端1.6 cm的第三SAA无任何破裂迹象。由于病变的部位，给患者提供了腹腔镜动脉瘤切除术和脾切除术。结果：手术时间为90分钟，估计失血量为5 cc。术后胎儿监护正常。未观察到围手术期并发症。该患者在术后第3天出院。腹腔镜脾切除术后两个月，该患者分娩了健康状况良好的男婴。结论：尽管这是一种罕见的疾病，但在怀孕期间动脉瘤破裂的风险会增加。由于孕产妇和胎儿死亡率高，应进行选择性手术。腹腔镜手术是首选技术。

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