Splenic Rupture in Leukemia

Tartaglia, Anthony P.; Scharfman, William B.; Propp, Simon

doi:10.1056/nejm196207052670107

Cited by 13 publications

(1 citation statement)

References 4 publications

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“…Early diagnosis is of major importance because successful splenectomy has been recorded as an emergency procedure in cases of spontaneous splenic rupture in leukaemia (Cooray, 1952;Tartaglia, Scharfman and Propp, 1962).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous splenic rupture and pseudo-hyperkalaemia in chronic lymphatic leukaemia

Wilson

1976

Postgraduate Medical Journal

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SummaryTwo unusual complications are described in a patient who had chronic lymphatic leukaemia. Spontaneous rupture of the spleen occurred and was related to subcapsular infarction and haemorrhage. The possibility of this complication should always be considered when signs of an acute abdomen develop in a patient with leukaemia. The phenomenon of pseudo-hyperkalaemia was demonstrated. This was most likely due to increased leucocyte fragility in vitro.

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Section: Discussionmentioning

confidence: 99%

Spontaneous splenic rupture and pseudo-hyperkalaemia in chronic lymphatic leukaemia

Wilson

1976

Postgraduate Medical Journal

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Spontaneous rupture of the spleen in chronic lymphocytic leukemia

Stites¹,

Ultmann²

1966

Cancer

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A case of spontaneous rupture of the spleen in a 67‐year‐old woman with chronic lymphocytic leukemia is presented. The patient had been hospitalized and treated with chlorambucil but had complained of left upper quadrant pain during and subsequent to her hospitalization. Immediately prior to death this became extremely severe and the patient exhibited weakness and nausea. At autopsy generalized lymphadenopathy and hepatosplenomegaly were noted. Other cases of spontaneous rupture of the spleen also are summarized from the literature. Only 32 cases have been found in leukemic patients and all but 3 have been in men. Although spontaneous rupture of the spleen is an unusual occurrence, the authors conclude that in some cases there is no history of injury or stress.

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Splenic rupture in patients with hematologic malignancies

Bauer

Haskins

Armitage

1981

Cancer

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Five cases of pathologic rupture of the spleen in patients with hematologic malignancy are presented along with a review of the 48 cases previously described in the English literature. Pathologic splenic rupture occurred most commonly in patients with acute leukemia but has been well documented in chronic leukemias and in lymphoma as well. Nearly all patients experience abdominal pain at the time of rupture; however, this pain was frequently confused clinically with that of biliary tract obstruction, aortic aneurysm, perforated viscus, pancreatitis, and angina pectoris. Pain referred to the left shoulder (Kehr's sign) was present in only 17% of patients. Hypotension was documented in 66%, fever in 74%, and tachycardia in 75%. The most effective diagnostic procedure was paracentesis, which confirmed intraabdominal hemorrhage in each of the nine cases in which the procedure was used. A correct preoperative diagnosis of splenic rupture was reported in only 10 of the 53 cases reviewed. Fifty-two percent of the patients underwent laparotomy; 48% died without operation. Of those that underwent surgery, 78% survived the procedure and the immediate postoperative period. The survival rate of all patients was 38%. There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival. The most important factor in predicting survival was appropriate surgery.

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Splenic Rupture in Leukemia

Cited by 13 publications

References 4 publications

Spontaneous splenic rupture and pseudo-hyperkalaemia in chronic lymphatic leukaemia

Spontaneous splenic rupture and pseudo-hyperkalaemia in chronic lymphatic leukaemia

Spontaneous rupture of the spleen in chronic lymphocytic leukemia

Splenic rupture in patients with hematologic malignancies

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