Splenic rupture after sexual intercourse in a pregnant woman: an extremely rare case

A 33-year-old pregnant woman presented at 36 weeks gestation to the emergency with acute abdominal pain that started after vaginal intercourse. No bruising was present on the abdominal examination. An emergent cesarean delivery was performed for resistant hypotension and collapse. A fetus with cardiac arrest was delivered, and active spleen bleeding was identified at the splenocolic and gastrosplenic ligament insertion. The patient had a conservative treatment of the spleen and an uncomplicated postoperative course. The infant was resuscitated and discharged after 18 days. In conclusion, traumatic spleen rupture is an etiology to consider in pregnant women presenting with acute abdominal pain following sexual intercourse. Early suspicion and emergent cesarean delivery are the keys to optimize maternal and perinatal outcomes.

Anomalous Course of Accessory Splenic Arteries in Gastrosplenic Ligament: Case Report and Clinico-Embryological Basis

Accessory splenic arteries in the gastrosplenic ligament constitute one of the extremely sub-component of abdominal vasculature variations and it is imperative to recognize this anomaly while planning for complex surgeries in the supra-colic compartment. We report the case of accessory splenic arteries in an approximately 50-year-old male cadaver encountered during routine educational dissection. One of them arising from left gastroepiploic artery supplies the spleen in addition to splenic artery. Another variant vessel bifurcated to enter greater omentum and anterior pole of spleen, as discrete branches. The anatomical vascular variation, if recognized during the imaging work-ups for elective surgical procedures could avoid potential iatrogenic blood loss.

Accessory spleen - In clinical perspective

Accessory spleen is a developmental anomaly of spleen with an incidence of 10-30% of the population. During routine cadaveric dissection in the department of Anatomy, BIMS, Belgaum, a case of accessory spleen was found in a middle aged female cadaver. The accessory spleen was located in the gastrosplenic ligament with size less than 3 cm in diameter. The embryological basis of this splenic anomaly and its clinical implications are discussed in this article.