scholarly journals A Case of a Chronic Pancreatic Pseudocyst Causing Atraumatic Splenic Rupture without Evidence of Acute Pancreatitis

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
P. Moori ◽  
E. J. Nevins ◽  
T. Wright ◽  
C. Bromley ◽  
Y. Rado
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Pancreatic Pseudocyst ◽  
Splenic Rupture ◽  
Rare Complication ◽  
Splenic Hilum ◽  
History Of ◽  
Excessive Alcohol ◽  
Atraumatic Splenic Rupture ◽  
Common Understanding

Atraumatic splenic rupture is a rare complication of a pancreatic pseudocyst (PP), described in the setting of chronic pancreatitis. There is common understanding, within the literature, that an inflammatory process at the tail of the pancreas may disrupt the spleen and result in such splenic complications. The authors present a case report of a 29-year-old male with a PP, associated with chronic pancreatitis. The patient had a history of excessive alcohol intake and presented to the emergency department with a short history of abdominal pain and vomiting. He denied any significant history of trauma and serum amylase levels were normal. An admission computed tomography (CT) scan of the abdomen confirmed the presence of a PP in direct contact with the spleen. The CT also demonstrated a heterogenous hypodense area of the splenic hilum, along with perisplenic fluid. The patient was admitted for observation. His abdominal pain progressed, and he became haemodynamically unstable. An emergency ultrasound scan (USS) at this time revealed intra-abdominal haemorrhage. A subsequent CT confirmed splenic rupture, which was managed surgically with a full recovery. Few such cases are documented within the literature and more understanding of preempting such events is needed.

scholarly journals Atraumatic Splenic Rupture is a Rare Complication of Acute Myeloid Leukemia: A Case Report and Literature Review

2021 ◽  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Rare Complication ◽  
Bone Marrow Aspiration ◽  
Underlying Disease ◽  
Free Fluid ◽  
Histopathological Study ◽  
Emergency Laparotomy ◽  
Limited Information ◽  
Atraumatic Splenic Rupture

Introduction: Atraumatic Splenic Rupture (ASR) is a rare but life-threatening clinicopathological phenomenon with limited information on patient features, occurrence, or etiology. Case presentation: A 48-year-old man with no history of the underlying disease presented to the emergency department with abdominal pain. He was admitted with leukocytosis 145x103/µl, hemoglobin 6.4 g/dl, and platelets 15x103/µl, ESR 89mm/h, D-Dimer 1043ng/FEU ml. Sputum test (PCR) ruled out SARS-CoV-2 infection. Due to peripheral blood smear and bone marrow aspiration/biopsy, AML was diagnosed for the patient. On the third day of hospitalization, the patient's abdominal pain intensifies. Ultrasound revealed medium free fluid inside the abdomen and pelvis. The patient was transferred to the operating room to undergo an emergency laparotomy. There was a large hematoma in the spleen with a rupture in its posterior surface. Splenectomy was performed. The histopathological study of the spleen showed leukemic involvement, capsular ruptures, and subcapsular hematomas. Discussion: ASR is an uncommon and lethal complication that is seen in infectious diseases (mainly mononucleosis) and hematological diseases (mainly malignant homeopathies) in more than half of cases. Mortality is approximately around 20%. Some deaths occur before the diagnosis is confirmed, while others occur after surgery, as a result of delayed management and poor patient status. Conclusion: ASR can occur for a variety of reasons, including non-traumatic or idiopathic factors. In the absence of significant trauma, emergency physicians should be aware that splenic rupture can occur. ASR is more likely to present with symptoms similar to the underlying disease.

Atraumatic splenic rupture in patient with acute pancreatitis

2021 ◽  
Vol 14 (3) ◽  
pp. e238559
Author(s):  
Roshini Nadaraja ◽  
Zarif Yahya ◽  
Krinal Mori ◽  
Ahmad Aly
Keyword(s):  
Acute Pancreatitis ◽  
High Mortality ◽  
Splenic Rupture ◽  
Rare Complication ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
Atraumatic Splenic Rupture

Atraumatic splenic rupture (ASR) is a rare complication of acute pancreatitis with high mortality and morbidity rates. We present a case of a 63-year-old woman with a history of hypertension, presenting with acute pancreatitis who subsequently developed a splenic rupture requiring a laparotomy and splenectomy. ASR is a rare but life-threatening complication requiring prompt recognition and management and should be considered in patient with pancreatitis who develops sudden haemodynamic compromise and worsening anaemia.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

scholarly journals Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marcello Agus ◽  
Maria Elena Ferrara ◽  
Paola Bianco ◽  
Cristina Manieli ◽  
Paolo Mura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Delayed Diagnosis ◽  
Caucasian Woman ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Rupture Of The Spleen ◽  
Delay Of Diagnosis ◽  
Possible Cause

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

scholarly journals Spontaneous splenic rupture in a patient with infectious mononucleosis

2019 ◽  
Vol 12 (9) ◽  
pp. e230259
Author(s):  
Charlotte Ruth Baker ◽  
Sid Kona
Keyword(s):  
Epstein Barr Virus ◽  
Splenic Rupture ◽  
Rare Complication ◽  
Young Female ◽  
Pleuritic Chest Pain ◽  
Diagnostic Challenge ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr ◽  
Atraumatic Splenic Rupture

We present a case of spontaneous, atraumatic splenic rupture secondary to Epstein-Barr virus (EBV) infection, in a young, female patient. Splenic rupture is a rare complication of EBV infection, but is associated with the highest mortality. Additionally, this case illustrates the diagnostic challenge in a patient presenting in atypical manner, with only left-sided pleuritic chest pain, and lacking any of the classical tonsillitis symptoms associated with EBV infection.

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

scholarly journals Procidencia with rare complication -a case report

KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 262-264
Author(s):  
Mst Atia Sultana ◽  
Monira Akter ◽  
Shafiul Anam
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Rare Complication ◽  
Lower Abdominal Pain ◽  
Chemical Substances ◽  
Abdominal Tenderness ◽  
History Of

Mrs. Lalbanu 65 years old lady presented to us with the complaints of something coming down per vagina for 10 years, foul smelling discharge for 2 months, fever & maggot formation for 5 days, she  also gave history of applying some chemical substances on her prolapsed mass of genitalia, and she also complains of lower abdominal pain for last 5 days. On examination, prolapsed mass was distorted, edematous, infected, irreducible & there were maggots, her temperature was raised & having lower abdominal tenderness. She was treated at first conservatively & then surgically. Now  she is well & with our follow up.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13662 KYAMC Journal Vol. 3, No.-1, June 2012 pp.262-264

scholarly journals SAT-579 Experiences with Hypertriglyceridemic Pancreatitis: A Mini Case Series

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Priyanka Majety ◽  
Richard D Siegel
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Early Recognition ◽  
Rare Complication ◽  
Case Series ◽  
Diagnostic Challenge ◽  
Eruptive Xanthomas ◽  
History Of ◽  
Appropriate Therapy ◽  
Pruritic Skin

Abstract Background: Hypertriglyceridemia (HTG) is a well-established cause of acute pancreatitis (AP) in up to 14% of all cases & up to 56% cases during pregnancy. The triad of HTG, Diabetic ketoacidosis (DKA) and AP is rarely seen posing diagnostic challenges. Early recognition of HTG-induced pancreatitis (HTGP) is important to provide appropriate therapy & prevent recurrence. In this case series, we discuss the diagnostic challenges and clinical features of HTGP. Clinical cases: Our first patient was a 65-year-old male with a history of hypertension who presented to the ER with abdominal pain and new-onset pruritic skin rash after a heavy meal. His exam and labs were notable for a diffuse papular rash on his back, triglycerides (TG) of 7073mg/dL (normal: &lt;150mg/dL). The rash improved with the resolution of HTG. Our second patient was a 29-year-old male with a history of alcohol dependence who was found to have AP complicated by ARDS requiring intubation. Further testing revealed that his TG was 12,862mg/dL & his sodium (Na) was 102mEq/L. Although HTG was known to cause pseudohyponatremia, it was a diagnostic challenge to estimate the true Na level. In a third scenario, a 28-year-old female with a history of T2DM on Insulin presented with nausea & abdominal pain. Labs were suggestive of DKA and lipase was normal. CT abdomen showed changes consistent with AP. The TG level that was later added on was elevated to 4413mg/dL. She was treated with insulin that improved her TG level. Discussion: We present three cases of hypertriglyceridemic pancreatitis. While the presentation can be similar to other causes of acute pancreatitis (AP), there are factors in the diagnosis and management of HTGP that are important to understand. Occasionally, physical exam findings can be suggestive of underlying HTG. In the first scenario, our patient presented with eruptive xanthomas - a sudden eruption of crops of papules that can be pruritic. They are highly suggestive of HTG, often associated with serum TG levels &gt; 1500mg/dL. Our second patient presented with pseudohyponatremia. HTG falsely lowers Na level, by affecting the percentage of water in plasma. Identifying this condition is important to prevent possible complications from aggressive treatment. This can be corrected either by using direct ion-specific electrodes or with the formula: Na change = TG * 0.002. DKA is associated with mild-moderate HTG in 30–50% cases. This is due to insulin deficiency causing activation of lipolysis in adipocytes & decreased activity of lipoprotein lipase (LPL). However, severe HTG is a rare complication of DKA, increasing the risk of AP. Diagnosis of AP in DKA poses many challenges: the common presenting complaint of abdominal pain, non-specific hyperlipasemia in DKA. AP with DKA has also been associated with normal lipase levels. A high clinical index of suspicion is required to diagnose HTGP in patients with DKA.

scholarly journals A Rare Case of Atraumatic Splenic Rupture Due to Chronic Pancreatitis

Cureus ◽  
2021 ◽  
Author(s):  
Rita Martelo ◽  
João C Morais ◽  
Angeles Rábago ◽  
Inês C Borges ◽  
Francisco Rodrigues
Keyword(s):  
Chronic Pancreatitis ◽  
Rare Case ◽  
Splenic Rupture ◽  
Atraumatic Splenic Rupture

Abstract 17237: A Pair Of Diaphragm-Crossed Organs: A Pancreatico-Pericardial Fistula

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Mary Pelling ◽  
Lena Chu ◽  
Krishan J Patel ◽  
Amalia Aldredge ◽  
Matthew T Brown
Keyword(s):  
Chronic Pancreatitis ◽  
Pericardial Effusion ◽  
Percutaneous Drainage ◽  
Rare Complication ◽  
Endoscopic Stenting ◽  
Successful Resolution ◽  
History Of ◽  
Pancreatic Fistulas ◽  
High Concentrations ◽  
Immunodeficiency Syndrome

Introduction: Pseudocysts are a known complication of chronic pancreatitis, occurring in 30-40% of patients. They form when disruption of the pancreatic duct system creates fluid-filled pockets with high concentrations of digestive enzymes. Leakage of these enzymes can create pancreatic fistulas. Here, we present a case of an unusual fistula that occurred in an immunocompromised individual. Case Description: A 34-year-old man with a history of Acquired Immunodeficiency Syndrome, alcohol use disorder, and chronic pancreatitis who had recently recovered from acute pancreatitis complicated by pericardial effusion was readmitted with worsening pleuritic chest pain and shortness of breath. He was hemodynamically stable with a normal cardiopulmonary exam without jugular venous distention or pulsus paradoxus. Labs were at his baseline other than an elevated d-dimer level. Computed tomography scan revealed a large, loculated pericardial effusion with a fistula extending through the diaphragm to a large peripancreatic pseudocyst. Gastroenterology performed pancreatic ductal stenting via endoscopic retrograde cholangiopancreatography and Interventional Radiology placed a percutaneous drainage catheter to facilitate resolution of the pseudocyst. Discussion: A pancreatico-pericardial fistula is a very rare complication of chronic pancreatitis. A 2016 review detailed only fifteen cases over a 40-year span with surgical management providing the best outcomes. Given this patient’s immunocompromise and malnutrition surgery was not offered, but endoscopic stenting and percutaneous drainage allowed for successful resolution of his fistula.

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