scholarly journals Splenic rupture after elective cardioversion

2019 ◽  
Vol 12 (4) ◽  
pp. e226679
Author(s):  
Farid John Kehdy ◽  
Emily Rapstine Bond
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Blunt Trauma ◽  
Splenic Injury ◽  
Splenic Rupture ◽  
Case Reports ◽  
Uneventful Recovery ◽  
Spontaneous Splenic Rupture ◽  
Systemic Anticoagulation

Splenic laceration and rupture are common phenomena among patients in a traumatic setting, especially in blunt trauma. Much more unusual, however, is splenic injury without a known insult. Several case reports and studies have been written about spontaneous splenic injury in patients with viral, haematological or malignant processes. Recently, we encountered a patient with a spontaneous splenic rupture and no preceding trauma apart from semielective cardioversion. Operative decision-making was complicated by the fact that he required systemic anticoagulation for atrial fibrillation. He eventually underwent splenectomy and made an uneventful recovery.

scholarly journals Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Jared Williams ◽  
Shingi Chiruka
Keyword(s):  
High Risk ◽  
Mantle Cell Lymphoma ◽  
Rare Case ◽  
Splenic Rupture ◽  
Cell Lymphoma ◽  
Case Reports ◽  
Spontaneous Splenic Rupture ◽  
Rare Type ◽  
Mantle Cell ◽  
Life Threatening

Mantle cell lymphoma is a relatively rare type of mature B-cell non-Hodgkin’s lymphoma with an incidence of approximately 8 cases per million persons per year. In patients with mantle cell lymphoma, there are rare case reports of the potentially life-threatening consequences of splenic rupture and rituximab-induced acute thrombocytopenia (RIAT) occurring separately, but there are no reports of these occurring in the same patient. Whilst rare, they are important to be aware of as early detection may prevent fatal outcomes.

scholarly journals Delayed diagnosis of splenic rupture following minor trauma: Beware of comorbid conditions

CJEM ◽  
2004 ◽  
Vol 6 (03) ◽  
pp. 217-219 ◽  
Author(s):  
Mohamed Ali Peera ◽  
Eddy S. Lang
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Splenic Injury ◽  
Splenic Rupture ◽  
Delayed Diagnosis ◽  
Lymphocytic Leukemia ◽  
Minor Trauma ◽  
Spontaneous Splenic Rupture ◽  
Comorbid Conditions ◽  
History Of

ABSTRACT Although rare, spontaneous splenic rupture has been reported in cases of chronic lymphocytic leukemia (CLL). In contrast, there are no published reports of splenic injury resulting from minor trauma in CLL patients. We report the case of an 81-year-old woman with a history of CLL, who presented with minor trauma to her coccygeal region, and was found to have a splenic rupture. We briefly describe the incidence, pathogenesis, presentation, diagnosis, management and prognosis of splenic injury, especially in cases with a history of splenomegaly.

scholarly journals Spontaneous Splenic Rupture in Malaria Patients: Two Case Reports

Cureus ◽  
2021 ◽  
Author(s):  
Ahmed M Alani ◽  
Jouhar J Kolleri ◽  
Ahmad Al Ekeer ◽  
Zeinab Alsiddig A Ibrahim
Keyword(s):  
Splenic Rupture ◽  
Case Reports ◽  
Spontaneous Splenic Rupture

scholarly journals Spontaneous splenic rupture: a rare first presentation of diffuse large B cell lymphoma

2019 ◽  
Vol 12 (8) ◽  
pp. e231101
Author(s):  
Louise Dunphy ◽  
Syed Hussain Abbas ◽  
Arjun Patel ◽  
Giovanni Tebala
Keyword(s):  
B Cell ◽  
Splenic Injury ◽  
Splenic Rupture ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Free Fluid ◽  
Spontaneous Splenic Rupture ◽  
Large B Cell Lymphoma ◽  
Ct Angiogram ◽  
Large B Cell

Spontaneous splenic rupture (SSR) is a rare but potentially life-threatening entity. It can be due to neoplastic, infectious, haematological, inflammatory and metabolic causes. An iatrogenic or an idiopathic aetiology should also be considered. Depending on the degree of splenic injury and the haemodynamic status of the patient, it can be managed conservatively. A 61-year-old man presented to the emergency department with an acute abdomen, hypovolaemic shock and clotting abnormalities. However, his focused assessment with sonography for trauma showed no evidence of an aortic aneurysm, rupture or dissection. Further investigation with a CT angiogram aorta confirmed a subcapsular splenic haematoma with free fluid in the pelvis and a mass in the superior pole of the spleen. He was diagnosed with an SSR. He was initially managed non-operatively. However, his repeat CT showed an enlarging haematoma and he underwent embolisation of his splenic artery. Ultrasound-guided core biopsy of his splenic mass confirmed the diagnosis of diffuse large B-cell lymphoma. This paper will discuss the clinical presentation, differential diagnosis and management of SSR. Furthermore, it provides an important clinical lesson to maintain a high index of clinical suspicion for splenic injury in patients presenting with left upper quadrant abdominal pain radiating to the shoulder. This case also reinforces the importance of close observation and monitoring of those individuals treated conservatively for signs of clinical deterioration.

Navigating the Management of an F-16 Pilot Following Spontaneous Splenic Rupture

2019 ◽  
Vol 90 (12) ◽  
pp. 1061-1063
Author(s):  
Michael Tanael ◽  
Solomon Saul
Keyword(s):  
Splenic Artery ◽  
Splenic Injury ◽  
Splenic Rupture ◽  
Splenic Tissue ◽  
Minimal Risk ◽  
Spontaneous Splenic Rupture ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Increased Risk ◽  
Asplenic Patient

BACKGROUND: Little consensus exists on the best practices for post-acute care of patients who suffer splenic injury but retain functional splenic tissue. Moreover, no published guidance or case reports exist for managing pilots in this demographic, making the flight surgeon’s task particularly difficulty as he/she attempts to apply the best available evidence for a patient population exposed to unique occupational hazards.CASE REPORT: We describe the case of an F-16 pilot who suffered a spontaneous splenic rupture due to infectious mononucleosis and required splenic artery embolization for hemodynamic stabilization. Despite the salvage of a significant portion of his spleen, the pilot was managed as an asplenic patient due to concern that: 1) splenic artery embolization compromised the function of his spleen; and 2) his status as a military aviator placed him at increased risk of infection due to frequent travel. He received appropriate vaccinations for an asplenic patient, fever precautions, and amoxicillin-clavulanic acid for immediate use if he developed fever. After discussion with the Aeromedical Consult Service, who felt the aviator had minimal risk of a poor outcome, he was returned to flying status. Since returning to flying status he has logged over 15 h of flight time, routinely experiencing 8–9 +Gz without difficulty.DISCUSSION: This case provides a successful approach to the management of pilots of high-performance aircraft who suffer splenic injury but retain functional splenic tissue, and provides precedent for safely returning these patients to flying status following recovery.Tanael M, Saul S. Navigating the management of an F-16 pilot following spontaneous splenic rupture. Aerosp Med Hum Perform. 2019; 90(12):1061–1063.

scholarly journals Association of Splenic Rupture and Infectious Mononucleosis: A Retrospective Analysis and Review of Return-to-Play Recommendations

2019 ◽  
Vol 11 (6) ◽  
pp. 543-549
Author(s):  
Jillian E. Sylvester ◽  
Benjamin K. Buchanan ◽  
Scott L. Paradise ◽  
Joshua J. Yauger ◽  
Anthony I. Beutler
Keyword(s):  
Infectious Mononucleosis ◽  
Symptom Onset ◽  
Splenic Injury ◽  
Splenic Rupture ◽  
Case Reports ◽  
Case Series ◽  
Return To Play ◽  
Military Health ◽  
Activity Restriction ◽  
Current Guidelines

Background: Infectious mononucleosis is typically a self-limited disease commonly affecting young adults. Splenic rupture is a rare but serious complication affecting 0.1% to 0.5% of patients with mononucleosis. Current guidelines (based on published case reports) recommend complete activity restriction for 3 weeks after onset of mononucleosis symptoms to reduce rupture risk. We examined actual timing of mononucleosis-associated splenic injury using a large repository of unpublished patient data. Hypothesis: The risk of splenic injury after infectious mononucleosis will remain elevated longer than previously estimated. Study Design: Retrospective case series. Level of Evidence: Level 4. Methods: The Military Health System Management Analysis and Reporting Tool (M2) was used to conduct a retrospective chart review. Coding records of TRICARE beneficiaries aged 5 to 65 years between 2006 and 2016 were screened. Patients diagnosed with both splenic injury and mononucleosis-like symptoms were identified, and their medical records were reviewed for laboratory confirmation of infection and radiographically evident splenic injury. Results: A total of 826 records of splenic injury were found in M2. Of these, 42 cases met the study criteria. Mean time to splenic injury was 15.4 (±13.5) days. Only 73.8% (n = 31) of injuries occurred within 21 days, and 90.5% (n = 38) of splenic injuries occurred within 31 days of symptom onset. Conclusion: A substantial number of splenic injuries occur between 21 and 31 days after symptom onset. While most splenic injuries were atraumatic, consideration should be given to extending return-to-play guidelines to 31 days after symptom onset to minimize risk. Risk of chronic pain after splenic injury may be higher than previously believed. Clinical Relevance: The risk for postmononucleosis splenic injuries remains elevated longer than current guidelines suggest. Restricting activity for 31 days after mononucleosis symptom onset may reduce the risk of splenic injury.

scholarly journals Spontaneous Splenic Rupture due to Metastatic Pancreatic Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
D. Politis ◽  
D. Myoteri ◽  
M. Bourou ◽  
C. Nastos ◽  
I. Papaconstantinou ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Splenic Rupture ◽  
Case Reports ◽  
Hypovolemic Shock ◽  
Rare Event ◽  
Malignant Neoplasm ◽  
Metastatic Pancreatic Cancer ◽  
Left Shoulder ◽  
Pathophysiological Mechanism ◽  
Spontaneous Splenic Rupture

Introduction. Nontraumatic splenic rupture is a rare event. On the other hand, splenic metastasis is also rare and usually found in the context of disseminated disease. Spontaneous splenic rupture caused by a metastatic deposit has been reported only as case reports. To the best of our knowledge, pancreatic cancer being the primary site has been reported in only a handful of cases. Case Presentation. A case of spontaneous splenic rupture in a 68-year-old male presenting with acute onset left shoulder pain, caused by metastatic pancreatic cancer to the spleen, is presented herein. During the investigation, the patient developed hypovolemic shock due to intra-abdominal hemorrhage, necessitating emergency splenectomy. The patient recovered well and was discharged from the hospital on the 8th postoperative day. Discussion. This study underlines the fact that the spleen is a rare site of metastasis, remaining mostly asymptomatic. However, it can nevertheless prove to be a life-threatening condition. The exact pathophysiological mechanism of splenic rupture due to metastasis still remains unknown, requiring further research. Emergency splenectomy remains the standard of care, and this clinical condition should be considered in the differential diagnosis of cases with acute abdomen and malignant neoplasm history.

Spontaneous splenic rupture due to rivaroxaban

2018 ◽  
Vol 56 (11) ◽  
pp. 136-139 ◽  
Author(s):  
Vinayak Nagaraja ◽  
Greg Cranney ◽  
Virag Kushwaha
Keyword(s):  
Adverse Effects ◽  
Splenic Rupture ◽  
Case Reports ◽  
Spontaneous Splenic Rupture ◽  
Limited Knowledge

In conjunction withBMJ Case Reports,DTBwill feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.

scholarly journals Spontaneous Splenic Rupture Four Days after an Open Appendicectomy

2015 ◽  
Vol 97 (2) ◽  
pp. e23-e24
Author(s):  
R Parker ◽  
G Gravante ◽  
M Elshaer ◽  
N Humayun ◽  
H Ebdewi
Keyword(s):  
Splenic Rupture ◽  
Case Reports ◽  
Iliac Fossa ◽  
Postoperative Bleeding ◽  
Haemorrhagic Shock ◽  
Spontaneous Splenic Rupture ◽  
Open Appendicectomy ◽  
Predisposing Factor ◽  
Midline Laparotomy ◽  
The Right

Introduction Spontaneous splenic rupture is a rare but dangerous event that requires prompt diagnosis and frequently an emergency splenectomy. Previous case reports have described the occurrence in patients with medical conditions, anticoagulant treatments, endoscopic procedures, laparoscopic surgery or no particular predisposing factor. Our report is the first to describe the occurrence of spontaneous spleen rupture following a laparotomy conducted in the lower abdomen. Case History A 62-year-old woman presented with a 10-day history of right iliac fossa pain radiating to the right leg and associated vomiting. Following a routine blood check and computed tomography (CT), she underwent an open appendicectomy through a lower midline laparotomy for an appendicular abscess. Four days later, she experienced haemorrhagic shock and a second CT scan diagnosed a spontaneous splenic rupture that required a prompt splenectomy. Conclusions Our case is the first that describes the spontaneous rupture of the spleen following an open procedure conducted in the lower quadrants. This entity must still be considered as a rare but potential cause for postoperative bleeding when no other obvious sources are identified.

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