Identification and Management of Non-traumatic Splenic Rupture

Silva, Samanthi De

doi:10.1177/175045891702701202

Cited by 4 publications

(3 citation statements)

References 11 publications

(4 reference statements)

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“…Infectious and hematological diseases represent more than half of its causes, infections are due to: infectious mononucleosis, malaria and cytomegalovirus, while hematological causes are mainly due to malignant tumors such as leukemia, Hodgkin's and non-Hodgkin's lymphomas (NHL) [ 3 ]. Other cases of spontaneous rupture of the spleen include: congenital splenic lesions such as hamartoma and hemangioma, spleen infarction, clotting disorders, thrombocytopenia, autoimmune diseases, hemolytic anemia, pregnancy, amyloidosis, portal hypertension and focal splenic lesions [ 1 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case

Hajri

Yaqine

Massi

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Spontaneous rupture of the spleen (SPR) is a rare and severe affection, difficult to diagnose, with multiple causes such as: Infectious and hematologic affections which represent more than half of the cases. Among this subset of patients, acute myeloid leukemia is one of the causes. Presentation of case A 48-year-old man undergoing chemotherapy for acute myeloid leukemia presented with acute intense abdominal pain. Computed tomography showed Abdominal CT scan showed a splenic rupture with abundant hemoperitoneum and bilateral pleural effusion. The patient presented hemodynamic instability and was immediately operated, splenectomy were performed. Discussion Spontaneous rupture of the spleen usually presents as a severe abdominal syndrome, which may accompany non-specific symptoms.Two signs are suggestive of splenic rupture: Kehr's sign (left diaphragmatic irritation resulting in referred pain to the left shoulder) and Balance's sign (palpable tender mass in the left upper quadrant. Diagnostic methods of choice are computed tomography andultrasound. The prognosis is depending on the quality of care and the nature of the etiology. Splenectomy remains the cornerstone of the treatment of splenic rupture. It is important to include splenic rupture as a differential diagnosis for acute abdominal pain, especially in patients with hematologic malignancy, since early recognition and treatment increase patient survival and improve the prognosis. Conclusion Even if spontaneous splenic rupture is rare, every clinician should have in mind the reflex to think of it, especially in patients with hematologic malignancies.

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Section: Discussionmentioning

confidence: 99%

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case

Hajri

Yaqine

Massi

et al. 2021

Annals of Medicine &Amp; Surgery

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“…Splenic rupture is the leading cause of death in infectious mononucleosis and should be considered in any patient with abdominal pain and known or suspected acute EBV infection[15,16]. The presence of left shoulder pain in this setting is known as Kehr’s sign and is present in 17% of patients with ASR[17].…”

Section: Discussionmentioning

confidence: 99%

Atraumatic splenic rupture after cocaine use and acute Epstein-Barr virus infection: A case report and review of literature

Kwok¹

2019

WJGS

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BACKGROUNDAtraumatic splenic rupture (ASR) accounts for just over 3% of all cases of splenic rupture and is associated with a high mortality rate. The most common culprit is acute infection with Epstein-Barr virus (EBV) but other documented aetiologies include neoplasia, other viral/bacterial infections, acute and chronic pancreatitis, amyloidosis and anticoagulant medications. There are four previous reports of cocaine-associated ASR but never before has it been documented in combination with concurrent acute EBV infection.CASE SUMMARYA 21-year-old man presented to hospital with acute left shoulder pain which radiated to the right shoulder and upper abdomen. He denied any history of recent trauma and had no relevant past medical history. He took no regular prescription medications but had used cocaine within the previous 24 h. Investigations revealed splenomegaly, a Grade 3 subcapsular splenic haematoma, moderate haemoperitoneum and an incidental 9 mm splenic artery pseudoaneurysm. There was also serological evidence of acute EBV infection. Prophylactic endovascular embolisation of the pseudoaneurysm was performed and the splenic rupture was managed non-operatively. The patient remained admitted in hospital for seven days and did not require any transfusion of blood products. Serial imaging showed complete resolution of the haemoperitoneum after 5 wk. The importance of abstinence from illicit drug use was emphasised to the patient but it is unknown whether or not he remains compliant.CONCLUSIONThis case demonstrates that ASR is a rare condition that can result from acute EBV infection and cocaine ingestion and requires a high index of suspicion to diagnose clinically.

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“…Infectious mononucleosis (IM) is usually a benign, selflimiting illness; younger patients often have a milder course, with the only exception of subjects with congenital immune deficiency. Splenic rupture is thus the leading cause of death [3,4].…”

Section: Cmentioning

confidence: 99%

A Teen-Ager with Life-Threatening Abdominal Pain

2022

Arch Surg Clin Case Rep

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Identification and Management of Non-traumatic Splenic Rupture

Cited by 4 publications

References 11 publications

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case

Atraumatic splenic rupture after cocaine use and acute Epstein-Barr virus infection: A case report and review of literature

A Teen-Ager with Life-Threatening Abdominal Pain

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