We report the case of a 24-year-old female patient with spontaneous rupture of a splenic artery aneurysm in the third trimester of pregnancy. Pregnancy, throughout the physiological and hormonal changes it imposes, promotes the occurrence of aneurysm of the splenic artery and its rupture. Although this is a rare complication, its prognosis is severe and its typical clinical picture associating abdominal pain, hypotension and anemia is misleading for the clinician who likelier evokes a retroplacental hematoma or an uterine rupture. The maternal and foetal survival depends on rapid diagnosis and multidisciplinary management. Thus, it's important for the clinician to consider this differential diagnosis when abdominal pain or hemoperitoneum occurs in pregnant woman, particularly during the third trimester of pregnancy.
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