Spontaneous splenic artery aneurysm rupture in a patient in late pregnancy: diagnostic challenges and management

This case describes a 36⁺⁶ weeks pregnant patient who presented with abdominal pain and rapidly developed haemorrhagic shock. Emergency laparotomy revealed a ruptured splenic artery aneurysm (SAA), requiring splenectomy. Her postoperative course was complicated by pulmonary embolism and acute kidney injury requiring long-term dialysis.While uterine rupture and placental abruption are common obstetric considerations in acute abdominal pain during pregnancy, this case highlights the importance of considering vascular pathologies such as SAA rupture, which carries high maternal and foetal mortality. Early recognition, prompt surgical intervention and multidisciplinary management are essential for improving outcomes in this rare but life-threatening condition. We aim to present a case of spontaneous rupture of SAA in pregnancy to raise awareness of this condition and emphasise the need for timely diagnosis, active resuscitation and management, including intensive treatment unit care and consideration of potential complications.