GP referral: incidental 2.4 cm splenic artery aneurysm in a 31-year-old woman planning pregnancy. Advice?

Question

Accepted Answer

Treat now (embolization/stent-graft): >2 cm plus anticipated pregnancy is an intervention indication because rupture risk rises sharply in pregnancy — Splenic artery aneurysms rupture disproportionately in pregnancy with catastrophic fetal and maternal mortality. The accepted thresholds: treat at >2–2.5 cm, and treat at smaller sizes in women who are or plan to become pregnant. Elective embolization now is a very different conversation than a rupture in the third trimester.

Answer

Surveillance — treat only above 5 cm

Answer

Treat now (embolization/stent-graft): >2 cm plus anticipated pregnancy is an intervention indication because rupture risk rises sharply in pregnancy

Answer

Aspirin

Answer

Splenectomy