Traumatic Rupture of Splenic Tissue 13 Years after Splenectomy. A Case Report

Abstract

After splenectomy, two types of splenic tissue can remain in the human body: one type is the congenital accessory spleen, with its own vasculature and capsule. The other type is the acquired splenosis, caused by the spread of splenic tissue following splenic injury. The aim of this paper is to briefly review the literature dealing with spontaneous bleeding of splenic tissue, apart from the primary spleen, and to report a case showing the clinical and surgical importance of remaining splenic tissue after splenectomy.

Accessory Spleen Fracture

“…5 Accessory spleen rupture is most often due to direct traumatic injury, often associated with BAT, [5][6][7][8][9] sometimes even in minor traumatic events. 5,9 However, spontaneous rupture of an accessory spleen has also been reported in otherwise healthy subjects, [10][11][12][13][14] without any evidence of previous trauma. Most of these patients presented with acute abdominal pain, [12][13][14] but initial progressive pain was also described, with 1 patient waiting up to 6 weeks before seeking medical assistance.…”

“…5,9 However, spontaneous rupture of an accessory spleen has also been reported in otherwise healthy subjects, [10][11][12][13][14] without any evidence of previous trauma. Most of these patients presented with acute abdominal pain, [12][13][14] but initial progressive pain was also described, with 1 patient waiting up to 6 weeks before seeking medical assistance. 10,11 Only very few cases are mentioned in the literature, and there is to our knowledge no data about associated mortality.…”

Recurrent Ruptured Spleen

“…In addition, in 2009 there was a report from Belgium of a traumatic rupture of splenic tissue 13 years after a splenectomy for idiopathic thrombocytopenic purpura. 1,2,3 …”

Abdominal splenosis with clinical presentation of metastatic neoplastic disease

“…Mimo że w piśmiennictwie można znaleźć doniesienia na temat powikłań splenozy [2,[12][13][14][15][16], najczęściej przebiega ona bez dolegliwości i jest rozpoznawana przypadkowo. Istotne znaczenie ma dokładnie zebrany wywiad dotyczący przebytych urazów i zabiegów operacyjnych jamy brzusznej.…”