Splenic peliosis associated with rupture in a renal transplant patient

Parsons, M A; Platts, Margaret M.; Slater, Dick; M, Fox

doi:10.1136/pgmj.56.661.796

Cited by 10 publications

(1 citation statement)

References 4 publications

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“…6 However, splenic rupture may present an emergency in a transplant patient. 7 Our patient underwent diagnostic laparotomy for unexplained hypovolemia in the posttransplant period, and he was found to have a ruptured spleen. Therefore, a splenectomy was performed.…”

Section: Discussionmentioning

confidence: 86%

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2016

Exp Clin Transplant

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Splenic peliosis is an exceedingly rare complication following liver and kidney transplant, with few previously reported cases. A 24-year-old man with chronic renal and hepatic failure due to primary oxalosis underwent concomitant renal and hepatic transplant. On the eighth day of successful transplant, he showed signs and symptoms of hypovolemia with suspicion of intra-abdominal bleeding. Diagnostic laparotomy was performed, yielding splenic rupture, and a splenectomy was performed. Macroscopically, the spleen was ruptured, and the cut surface displayed multiple parenchymal blood-filled cysts. Microscopically, the splenic microarchitecture was distorted by numerous irregular hemorrhagic lacunes partially lined by sinusoidal endothelium. Splenic peliosis was diagnosed. The patient recovered with splenectomy. Peliosis is a condition characterized by multiple bloodfilled cavities in parenchymatous organs, and it most frequently affects the liver. It is thought to be related to many conditions, including hematologic malignancies, acquired immuno deficiency syndrome, chronic alcoholism, use of oral contraceptives, and posttransplant immunodeficiency state. However, peliosis of the spleen, compared with the liver, is relatively rare, and it may cause spontaneous splenic rupture. Although rare, splenic peliosis and secondary splenic rupture is a significant posttransplant complications leading to unexplained hypovolemia.

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Section: Discussionmentioning

confidence: 86%