Spontaneous splenic rupture: A rare life-threatening condition; Diagnosed early and managed successfully

Weaver, Helen; Kumar, Virender; Spencer, Kate L.; Maatouk, Mohamed; Malik, Sohail

doi:10.12659/ajcr.883739

Cited by 31 publications

(25 citation statements)

References 4 publications

(7 reference statements)

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“…Therefore, we hypothesized that SSR may present with a different clinical and sonographic pattern and may have a different prognosis compared to TSR. The etiology, symptoms, diagnosis, B-mode appearance, treatment and clinical course have only been sporadically described for SSR 2 3 4 . Furthermore, to the best of our knowledge, there is no description of CEUS patterns of SSR in the literature.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

Rosling

Trenker

Neeße

et al. 2018

Ultrasound Int Open

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Introduction Both B-mode ultrasound and contrast-enhanced ultrasound (CEUS) are well established procedures when diagnosing traumatic splenic ruptures (TSR). To date, there are no data about CEUS patterns in spontaneous splenic ruptures (SSR). It remains unknown whether TSR and SSR differ with respect to clinical characteristics, B-mode and CEUS characteristics. Patients and Methods Between 12/2003 and 2/2010, n=33 SSRs and n=29 TSRs were diagnosed in a tertiary referral center. All patients were examined with B-mode and CEUS, and clinical data and the outcome were retrospectively analyzed. Results Patients with SSR were significantly older than patients with TSR (62 years vs. 44 years; p=0.01). The 4-week mortality was significantly higher in SSR than in TSR (36% vs. 0%; p=0.001). No differences between the grading of TSR and SSR could be shown in B-mode or in CEUS. Notably, CEUS was significantly superior to B-mode with respect to the grading of splenic ruptures (p=0.01). Therefore, therapeutic management was influenced by CEUS. Conclusion There are differences between SSR and TSR, especially concerning clinical data (age, course of disease and mortality). Regarding the sonographic pattern, SSR and TSR show identical grading. When splenic rupture is suspected, CEUS should always be performed to identify patients at risk who require interventional procedures.

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Section: Introductionmentioning

confidence: 99%

Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

Rosling

Trenker

Neeße

et al. 2018

Ultrasound Int Open

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“…A patient with infectious mononucleosis and splenic enlargement (splenomegaly) should be closely monitored. The pathologic splenic rupture is the most common cause of death in patients with infectious mononucleosis [4]. It has been believed that increased intra-abdominal pressure or diaphragmatic contraction during severe coughing, vomiting, and defecation, which leads to pressure on the spleen, is the cause of this type of splenic rupture [8].…”

Section: Discussionmentioning

confidence: 99%

“…Several grading systems have been established for splenic rupture based on CT scan or ultrasound ndings and each has been found to be effective in contributing to management and decision making. [4] However, there have been tremendous amount of case reports of atraumatic splenic rupture, there are not any comprehensive assessment to reveal the incidence rate, causes, speci c symptoms, available management methods, and the prognosis. [3]…”

Section: Introductionmentioning

confidence: 99%

The presentation of spontaneous splenic rupture in a COVID-19 patient: a case report

Mobayen

Yousefi

Mousavi

et al. 2020

Preprint

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Abstract Introduction: Splenic rupture is an emergency condition and the vast numbers of cases are secondary to trauma. Several underlying pathologies have also been associated with splenic rupture, such as hematological diseases, malignancies, and infectious and inflammatory diseases.Presentation of case: The patient was a 52-year-old man who referred to the Poursina Hospital in Rasht while complaining of abdominal pain from the day before hospitalization. The patient reported a history of lethargy, fever, and nausea. In the examinations performed, there was a brief tenderness in the patient's epigastrium. The patient was monitored and about 12 hours after hospitalization, ill appearance, respiratory (respiratory distress) symptoms, and high fever were reported for the patient. According to the examination, the patient was immediately transferred to the operating room and underwent laparotomy. During the operation, contrary to our expectations, a lot of blood (about 1000 cc) was observed in the patient's abdomen. After blood suctioning, the left upper quadrant (LUQ) was bleeding and the rupture of the spleen could also be observed. Therefore, a splenectomy was performed .In the examinations performed for the patient, the patient's rtPCR test confirmed COVID-19.Conclusion: The evaluation of the spontaneous splenic rupture (SSR) in our case shows that this type of risk should also be considered in patients with COVID-19 who referred to medical centers with abdominal pain, and if more cases are reported, the correctness of this process can be commented on.

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“…It has been reported that a diagnosis of a ruptured spleen is frequently not considered in the absence of trauma, even in the presence of pain in the upper left quadrant and hemodynamic instability, which can lead to devastating outcomes [18] . In these instances, the use of diagnostic tools may greatly increase an accurate diagnosis of atraumatic splenic rupture.…”

Section: Discussionmentioning

confidence: 99%

Atraumatic splenic rupture precipitated by splenic vein thrombosis

Zhou

Shah

Arthus

et al. 2016

Radiology Case Reports

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Spontaneous splenic rupture: A rare life-threatening condition; Diagnosed early and managed successfully

Cited by 31 publications

References 4 publications

Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

Spontaneous and Traumatic Splenic Rupture: Retrospective Clinical, B-Mode and CEUS Analysis in 62 Patients

The presentation of spontaneous splenic rupture in a COVID-19 patient: a case report

Atraumatic splenic rupture precipitated by splenic vein thrombosis

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