Splenic artery aneurysm rupture in the pregnant patient: The importance of utilising ultrasound to differentiate the acute abdomen from obstetric causes of abdominal pain

Although splenic artery aneurysm (SAA) rupture in the pregnant patient is considered a rare occurrence, its consequences can be catastrophic for both mother and fetus. The mortality rate from this entity in pregnancy is disproportionately high when compared with that of the general population, with multiparity thought to be a contributing factor. Potential reasons for this may be explained by its non‐specific abdominal symptoms often misdiagnosed as common obstetric differentials, combined with a rapid deterioration of patient condition post rupture. For these reasons, SAA rupture should have a high index of suspicion when a pregnant women presents with an acute abdomen, as a favourable outcome is dependent on prompt diagnosis and appropriate medical intervention. This article reviews the incidence of SAA rupture in pregnancy, outlines the pathophysiological processes that contribute to this entity being more prevalent in the gravid population, and displays the pivotal role ultrasound can play in expediting this diagnosis. In the emergency situation, ultrasound examination of a pregnant patient should be extended from a focussed pelvic study to encompass the entire abdominal cavity. Its portability combined with its nonionising nature makes ultrasound the modality of choice to reduce the time to diagnosis and thus influence treatment pathways.