Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy

Aim. Improving the diagnosis and treatment of complications of splenic artery fibromuscular malformation during pregnancy. Material and Methods. Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy are analyzed. Results and Discussion. In the firs...

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Autores principales:	I.I. Kobza, T.I. Kobza, Ya.M. Zborivskiy, Yu.S. Mota, V.P. Fedorenko, I.Ya. Schykula
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2016
Materias:	fibromuscular malformations of splenic artery, aneurysm, rupture, pregnancy, diagnosis, surgical treatment Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/5f1a4f7b8a6f416eb8077427170a598d
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spelling	oai:doaj.org-article:5f1a4f7b8a6f416eb8077427170a598d2021-11-10T19:50:04ZTwo cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy1029-42442415-3303https://doaj.org/article/5f1a4f7b8a6f416eb8077427170a598d2016-12-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/180https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303Aim. Improving the diagnosis and treatment of complications of splenic artery fibromuscular malformation during pregnancy. Material and Methods. Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy are analyzed. Results and Discussion. In the first case, a 34-year-old pregnant woman, in the 34-th week of the third pregnancy, the "string of beads" appearance of splenic artery, with 7-8 mm in diameter of proximal portion, 13-14 mm of middle portion, was identified. Caesarean section and splenectomy resulted in discharge of the mother and the baby in good condition on 11-th day. In the second case, in a 30-year-old pregnant woman, in the 30-th week of third pregnancy, a rupture of splenic artery aneurysm, intra-abdominal bleeding, hematoma, spreading on lesser and greater omentum and retroperitoneal tissue, and grade III of hemorrhagic shock caused antepartum fetal death. The splenectomy, Caesarean section in the lower segment of the uterus with removal of the dead fetus, ligation of both internal iliac arteries, and hysterectomy without ovaries were performed. Postoperatively the blockade of ureters at ovarian level, and bilateral ureterohydronephrosis were diagnosed, that resulted in the formation of a left-sided nephrostomy. Thus, early diagnosis, and emergency laparotomy with participation of abdominal and vascular surgeons are crucial in preserving the lives of the mother and the fetus. Conclusion. Splenic artery aneurysm against a background of fibromuscular malformation in pregnant women, a rare clinical disease that is often complicated by rupture and fatal bleeding, is a threat to life of the mother and the fetus. Оbstetricians-gynecologists and urgent abdominal surgeons should consider the rupture of splenic artery aneurysm in any pregnant woman admitted with suspected acute abdomen. Early diagnosis, and emergency laparotomy with participation of abdominal and vascular surgeons are crucial in preserving the lives of the mother and the fetus.I.I. KobzaT.I. KobzaYa.M. ZborivskiyYu.S. MotaV.P. FedorenkoI.Ya. SchykulaDanylo Halytsky Lviv National Medical Universityarticlefibromuscular malformations of splenic artery, aneurysm, rupture, pregnancy, diagnosis, surgical treatmentMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 22, Iss 4, Pp 69-73 (2016)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	fibromuscular malformations of splenic artery, aneurysm, rupture, pregnancy, diagnosis, surgical treatment Medicine (General) R5-920
spellingShingle	fibromuscular malformations of splenic artery, aneurysm, rupture, pregnancy, diagnosis, surgical treatment Medicine (General) R5-920 I.I. Kobza T.I. Kobza Ya.M. Zborivskiy Yu.S. Mota V.P. Fedorenko I.Ya. Schykula Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
description	Aim. Improving the diagnosis and treatment of complications of splenic artery fibromuscular malformation during pregnancy. Material and Methods. Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy are analyzed. Results and Discussion. In the first case, a 34-year-old pregnant woman, in the 34-th week of the third pregnancy, the "string of beads" appearance of splenic artery, with 7-8 mm in diameter of proximal portion, 13-14 mm of middle portion, was identified. Caesarean section and splenectomy resulted in discharge of the mother and the baby in good condition on 11-th day. In the second case, in a 30-year-old pregnant woman, in the 30-th week of third pregnancy, a rupture of splenic artery aneurysm, intra-abdominal bleeding, hematoma, spreading on lesser and greater omentum and retroperitoneal tissue, and grade III of hemorrhagic shock caused antepartum fetal death. The splenectomy, Caesarean section in the lower segment of the uterus with removal of the dead fetus, ligation of both internal iliac arteries, and hysterectomy without ovaries were performed. Postoperatively the blockade of ureters at ovarian level, and bilateral ureterohydronephrosis were diagnosed, that resulted in the formation of a left-sided nephrostomy. Thus, early diagnosis, and emergency laparotomy with participation of abdominal and vascular surgeons are crucial in preserving the lives of the mother and the fetus. Conclusion. Splenic artery aneurysm against a background of fibromuscular malformation in pregnant women, a rare clinical disease that is often complicated by rupture and fatal bleeding, is a threat to life of the mother and the fetus. Оbstetricians-gynecologists and urgent abdominal surgeons should consider the rupture of splenic artery aneurysm in any pregnant woman admitted with suspected acute abdomen. Early diagnosis, and emergency laparotomy with participation of abdominal and vascular surgeons are crucial in preserving the lives of the mother and the fetus.
format	article
author	I.I. Kobza T.I. Kobza Ya.M. Zborivskiy Yu.S. Mota V.P. Fedorenko I.Ya. Schykula
author_facet	I.I. Kobza T.I. Kobza Ya.M. Zborivskiy Yu.S. Mota V.P. Fedorenko I.Ya. Schykula
author_sort	I.I. Kobza
title	Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
title_short	Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
title_full	Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
title_fullStr	Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
title_full_unstemmed	Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
title_sort	two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2016
url	https://doaj.org/article/5f1a4f7b8a6f416eb8077427170a598d
work_keys_str_mv	AT iikobza twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy AT tikobza twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy AT yamzborivskiy twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy AT yusmota twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy AT vpfedorenko twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy AT iyaschykula twocasesofdiagnosisandtreatmentofsplenicarteryfibromuscularmalformationduringpregnancy
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Two cases of diagnosis and treatment of splenic artery fibromuscular malformation during pregnancy

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