Splenic artery aneurysm (SAA) rupture in pregnancy is an unpredictable and rare emergency associated with maternal and fetal mortality. Ruptured SAA is characteristically diagnosed at laparotomy and managed with splenectomy, with embolisation favoured for uncomplicated cases. We report a case of a ruptured SAA in a morbidly obese pregnant woman with medical comorbidities, who presented as a diagnostic dilemma, but was subsequently managed successfully with interventional radiology at the time of caesarean section.
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