Rupture of splenic artery aneurysm in pregnancy with double-rupture phenomenon: A case report

BACKGROUND: Rupture of a splenic artery aneurysm (SAA) is a rare and often life-threatening complication of pregnancy. The reported incidence is 0.01% to 10.4%. Maternal and fetal mortality have been reported to be as high as 75% and 95% respectively. CASE DESCRIPTION: A 26-year-old woman, gravida 5 para 3, presented at 32 weeks of gestation with diffuse abdominal pain and several episodes of syncope. An anchor diagnosis of abruption was made secondary to findings on presentation of intrauterine fetal demise and extensive history of substance abuse. DISCUSSION: This case is an example of anchoring bias despite good outcomes due to misleading prodromal and warning symptoms with initial favorable response to resuscitation. CONCLUSION: A ruptured SSA should be considered in the differential of severe and unexplained pain in the left upper quadrant in pregnancy. A high degree of suspicion is required to make this diagnosis.