Spontaneous rupture of the normal spleen

Morrin, F. J.; Guiney, E. J.

doi:10.1007/bf02953745

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…It accounts for up to 1% of all splenic ruptures [3]. In a comprehensive review article published in 2012 by AubreyBassler and Sowers [4], there were only 12 reported cases of spontaneous rupture of the normal spleen after coughing in English and French literature on human subjects between 1950 and 2011 [5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Biswas

Richards

2016

J Curr Surg

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Splenic rupture due to trauma is relatively common. However, spontaneous non-traumatic ruptures do occur. Causes include infection, neoplasia and infiltrative process. We present an unique case of a 59-year-old patient who presented with dyspnea and left upper abdominal discomfort following bouts of coughing, and was provisionally diagnosed as pulmonary embolism. CT scan revealed splenic rupture. Only a few case reports are published documenting spontaneous splenic rupture following coughing. The therapy of choice can vary between patients depending on the grade of splenic rupture, hemodynamic instability, availability of endovascular treatment and physician preference. Treatment should be focused on preserving splenic tissue if feasible. Non-traumatic rupture of the spleen must be considered in patients presenting with left-sided upper abdominal pain even without evident history of trauma, since early recognition and treatment can prevent serious morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Biswas

Richards

2016

J Curr Surg

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Splenic haematoma after spontaneous rupture of the spleen

Nicoll¹

1968

The American Journal of Surgery

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613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review

2012

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BackgroundRupture of the spleen in the absence of trauma or previously diagnosed disease is largely ignored in the emergency literature and is often not documented as such in journals from other fields. We have conducted a systematic review of the literature to highlight the surprisingly frequent occurrence of this phenomenon and to document the diversity of diseases that can present in this fashion.MethodsSystematic review of English and French language publications catalogued in Pubmed, Embase and CINAHL between 1950 and 2011.ResultsWe found 613 cases of splenic rupture meeting the criteria above, 327 of which occurred as the presenting complaint of an underlying disease and 112 of which occurred following a medical procedure. Rupture appeared to occur spontaneously in histologically normal (but not necessarily normal size) spleens in 35 cases and after minor trauma in 23 cases. Medications were implicated in 47 cases, a splenic or adjacent anatomical abnormality in 31 cases and pregnancy or its complications in 38 cases.The most common associated diseases were infectious (n = 143), haematologic (n = 84) and non-haematologic neoplasms (n = 48). Amyloidosis (n = 24), internal trauma such as cough or vomiting (n = 17) and rheumatologic diseases (n = 10) are less frequently reported. Colonoscopy (n = 87) was the procedure reported most frequently as a cause of rupture. The anatomic abnormalities associated with rupture include splenic cysts (n = 6), infarction (n = 6) and hamartomata (n = 5). Medications associated with rupture include anticoagulants (n = 21), thrombolytics (n = 13) and recombinant G-CSF (n = 10). Other causes or associations reported very infrequently include other endoscopy, pulmonary, cardiac or abdominal surgery, hysterectomy, peliosis, empyema, remote pancreato-renal transplant, thrombosed splenic vein, hemangiomata, pancreatic pseudocysts, splenic artery aneurysm, cholesterol embolism, splenic granuloma, congenital diaphragmatic hernia, rib exostosis, pancreatitis, Gaucher's disease, Wilson's disease, pheochromocytoma, afibrinogenemia and ruptured ectopic pregnancy.ConclusionsEmergency physicians should be attuned to the fact that rupture of the spleen can occur in the absence of major trauma or previously diagnosed splenic disease. The occurrence of such a rupture is likely to be the manifesting complaint of an underlying disease. Furthermore, colonoscopy should be more widely documented as a cause of splenic rupture.

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Spontaneous rupture of the normal spleen

Cited by 3 publications

References 22 publications

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Spontaneous Splenic Rupture Following Bouts of Coughing: A Rare Case Report and Literature Review

Splenic haematoma after spontaneous rupture of the spleen

613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review

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