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Case Presentation: The patient is an 18-year-old woman, 20 weeks pregnant, who came to the Emergency department of Bentolhoda Hospital in Bojnurd with diffuse sudden onset of abdominal pain in the September of 2023. On examination, the patient's vital signs were unstable, which was due to the presence of hemorrhagic shock. In the examination of the patient's abdomen, or generalized tenderness and rebound tenderness? was evident, suggesting peritonitis. According to the ultrasound report, abundant free fluid and fluid containing blood was drained from the abdomen under ultrasound guidance. The patient underwent surgery with the diagnosis of hemorrhagic shock with a midline incision of the abdomen above and below the umbilicus. In the performed surgery, evidence of splenic artery aneurysm rupture was evident. For the patient, ligature and resection of splenic vessels (artery and vein) and splenectomy were performed. After surgery and stabilization of the patient's condition, fetal health ultrasound was performed, and the fetus had no heartbeat. Therefore, medical induction of abortion was performed, and after 48 hours, the fetus was completely expelled, and then mother was transferred to the ward. And four days after the surgery, she was discharged with general improvement. No remarkable adverse effects were observed after surgery.
Conclusion: One of the rare diseases is splenic artery aneurysm, which is difficult to diagnose due to its asymptomatic rupture and high mortality rate.
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