Rupture of the spleen or a splenic artery can occur during late pregnancy. This can result in massive intra-abdominal bleeding that can be fatal to the mother and/or fetus.


The rupture may occur in the third trimester, during labor or in the postpartum period.


Clinical findings may include:

(1) abdominal pain in the left upper quadrant

(2) sudden onset of hypotension and shock

(3) abdominal tap showing gross blood


Possible explanations to consider:

(1) blunt trauma to the abdomen (car accident, fall, etc)

(2) intimate partner violence

(3) massive splenomegaly due to malaria, metabolic disease, etc.

(4) vasculitis

(5) vascular disease secondary to drug abuse (amphetamines, cocaine, etc)

(6) congenital malformation

(7) aneurysm of an artery

(8) connective tissue disorder affecting collagen or other structural component

(9) fibrodysplasia of the arterial wall

(10) idiopathic spontaneous rupture of the spleen


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