Characteristics of Patients With Spontaneous Splenic Rupture

Abstract In the present study, we aim to share our clinical experience in patients with spontaneous splenic rupture. Splenic rupture without trauma is known as spontaneous splenic rupture. The major problems in the management of spontaneous splenic rupture are missed or delayed diagnosis due to the lack of trauma in most cases. The records of all patients, who were admitted to Cerrahpaşa Medical Faculty, Istanbul University, were retrospectively reviewed from January 2000 to March 2013. Twelve patients were admitted to the emergency department and they were diagnosed with spontaneous splenic rupture. The mean age was 47.6 years. All patients had complaints of abdominal pain. The mean hematocrit value was 22%. Radiologic assessment revealed hemoperitoneum and/or subcapsular hematoma in 8 patients while splenic abscess was diagnosed in 2 patients. Eleven patients underwent splenectomy whereas one was managed conservatively. The most common cause of spontaneous splenic rupture was determined to be use of anticoagulants. Etiology was considered to be idiopathic in 1 patient. Two patients died in the postoperative period. Although rare, spontaneous splenic rupture must be suspected in emergency patients who have used especially anticoagulants and antiaggregants and who have had no recent history of trauma. One of the important causes of mortality is missed or delayed diagnosis.

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

CJEM ◽

10.1017/s1481803500006874 ◽

2004 ◽

Vol 6 (03) ◽

pp. 217-219 ◽

Cited By ~ 1

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.

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Adolescent With Spontaneous Splenic Rupture as a Cause of Hemoperitoneum in the Emergency Department

Pediatric Emergency Care ◽

10.1097/pec.0000000000001520 ◽

2018 ◽

Vol Publish Ahead of Print ◽

Author(s):

José Juan Gómez-Ramos ◽

Alejandro Marín-Medina ◽

Javier Lisjuan-Bracamontes ◽

Diana García-Ramírez ◽

Heriberto Gust-Parra ◽

...

Keyword(s):

Emergency Department ◽

Splenic Rupture ◽

Spontaneous Splenic Rupture

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Splenic abscess leading to spontaneous splenic rupture

Emergency Care Journal ◽

10.4081/ecj.2021.9204 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Annum A. Bhullar ◽

Caleb P. Canders ◽

Amir Rouhani ◽

Steven Lai

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Splenic Abscess ◽

Spontaneous Splenic Rupture ◽

Surgical History ◽

Missed Diagnosis ◽

Ruptured Spleen ◽

Upper Abdominal ◽

Rupture Of The Spleen ◽

Dental Work

Spontaneous, atraumatic rupture of the spleen is an uncommon but potentially fatal cause of acute abdominal pain. Splenic abscesses are equally rare and can be a risk factor for spontaneous splenic rupture. We present a 45-year-old man with no past medical or surgical history who presented with acute worsening of left upper abdominal pain that had been present for months, who was discovered to have a ruptured spleen. Splenic abscess was discovered intra-operatively and was thought to have developed after dental work. Recognizing presenting features of spontaneous splenic rupture and understanding its potential causes, such as splenic abscesses, may prevent delayed or missed diagnosis and guide treatment, which typically includes emergent splenectomy.

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STUDY OF CARDIOVASCULAR RISK FACTORS DURING GESTATIONAL DIABETES IN SENEGAL

10.36106/gjra/7112137 ◽

2021 ◽

pp. 98-102

Author(s):

Soumah I.Y ◽

Thiam S ◽

Toure Y ◽

Ndiaye A ◽

Samba A ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Gestational Diabetes ◽

Analytical Study ◽

Delayed Diagnosis ◽

Favourable Outcome ◽

Apo B ◽

History Of ◽

The Mean ◽

Lipid Parameters

The evolution of gestational diabetes is most often marked by preventable maternal-foetal complications. The objective of this study was to identify factors inuencing the development of pregnancy in women with gestational diabetes. This was a retrospective and analytical study including women with gestational diabetes and treated in gynaecological services in Dakar and its suburbs between 2018 and 2019. A total of 24 women with gestational diabetes were recruited. The mean age of the patients was 29.9 ± 6.45 years (18-45) with a predominance of women over 30 years old. Dyslipidaemias were frequent (91.2%) with a predominance of hypercholesterolemia (n = 13, 54.2%) followed by hyperLDLemia (n = 10, 41.7%). The atherogenic risk was high with the TG / HDL (12.5%) and Apo B / A (20.83%) ratios. A positive correlation was noted between homocysteine and total cholesterol (r = 0.457, p = 0.025), LDL (r = 0.449, p = 0.028), triglycerides (r = 0.540, p = 0.006), apolipoproteins A (r = 0.463, p = 0.023) and B (r = 0.480, p = 0.018), urea (r = 0.0671, p <0.0001) and creatinine (r = 0.0673, p <0, 0001). The development of the pregnancy was marked by caesarean deliveries (54.2%) and macrosomia (8.3%). The factors which were identied in relation to the caesarean section were delayed diagnosis of GD, history of personal abortion (RR (CI) = 2.04 (0.4 - 10.6)), multiparity (RR (CI)) = 2.3 (0.4 - 12.7)) and the advanced age of the woman (RR (CI) = 2.1 (0.5 - 14.4)). The biological monitoring of women with gestational diabetes must consider the dosage of lipid parameters extended to apolipoproteins and homocysteine for a favourable outcome of the pregnancy

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Identification and Management of Non-traumatic Splenic Rupture

Journal of Perioperative Practice ◽

10.1177/175045891702701202 ◽

2017 ◽

Vol 27 (12) ◽

pp. 296-297 ◽

Cited By ~ 1

Author(s):

S De Silva

Keyword(s):

Emergency Department ◽

Splenic Rupture ◽

Epigastric Pain ◽

Ultrasound Scan ◽

Past Medical History ◽

Computerised Tomography ◽

History Of ◽

Traumatic Splenic Rupture ◽

Obvious Source ◽

Rule Out

A 43-year old previously fit and well gentleman presented to the emergency department (ED) with a two day history of worsening epigastric pain. He had had coryzal symptoms the preceding week but had no other past medical history. He was haemodynamically stable at presentation and an ultrasound scan (US) performed in the ED could not definitively rule out intra-abdominal fluid. In view of his tender abdomen on examination and a haemoglobin level of 9.2g/dL, a computerised tomography (CT) scan was performed and revealed extensive high-density fluid within the peritoneal cavity, raising the possibility of a concealed bleed but no obvious source was identified by the scan.

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Spontaneous Splenic Rupture in Severe Dengue

Bangladesh Critical Care Journal ◽

10.3329/bccj.v1i1.14373 ◽

2013 ◽

Vol 1 (1) ◽

pp. 59-62 ◽

Cited By ~ 2

Author(s):

Ahmad Mursel Anam ◽

Mohammad Mufizul Islam Polash ◽

Md Motiul Islam ◽

Muhammad Mahbubur Rahman Bhuiyan ◽

ARM Nooruzzaman ◽

...

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Febrile Illness ◽

Acalculous Cholecystitis ◽

Severe Dengue ◽

Spontaneous Splenic Rupture ◽

History Of ◽

Plasma Leakage ◽

Laboratory Investigations ◽

High Index Of Suspicion

Dengue is a mosquito-borne systemic viral infection with variety of clinical presentation, ranging from mild febrile illness to severe and fatal disease. A patient presented with history of fever and abdominal pain, and later developed shock. From clinical and epidemiological features, he was diagnosed as a patient of severe dengue, later confirmed by laboratory investigations. In dengue, shock can result from plasma leakage, and abdominal pain may be a feature of acalculous cholecystitis or pancreatitis, recognised presentations of dengue and usually managed conservatively. But high index of suspicion persuaded abdominal imaging, revealing a potentially fatal complication of dengue- spontaneous splenic rupture. Aggressive resuscitation and early surgery saved the patient. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14373 Bangladesh Crit Care J March 2013; 1: 59-62

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Spontaneous splenic rupture in a patient receiving thrombolytic therapy

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492009005000015 ◽

2009 ◽

Vol 8 (3) ◽

pp. 274-276

Author(s):

Elizabeth Revesz ◽

John A. Grimaldi ◽

Elizabeth T. Clark ◽

Francis J. Podbielski

Keyword(s):

Thrombolytic Therapy ◽

Splenic Rupture ◽

Bypass Graft ◽

Hemodynamic Instability ◽

Sudden Onset ◽

Leg Pain ◽

Free Fluid ◽

Spontaneous Splenic Rupture ◽

Patient Reported ◽

History Of

We describe the case of a 67-year-old female patient with a history of femoral-distal bypass graft with sudden onset of unremitting leg pain, who had recently received tissue plasminogen activator (t-PA). The patient reported non-compliance with her warfarin regimen. Angiography revealed occlusion of the bypass graft. Infusion of t-PA was performed via a right femoral artery approach. On hospital day two, the patient developed nausea and abdominal pain with associated hypotension. A CT scan showed a massive intra-abdominal and pelvic free fluid consistent with blood. The spleen was enlarged and fluid noted around the liver. At laparotomy, a grade III splenic laceration at the hilum was identified and a splenectomy performed. The patient recovered completely. Although rare, spontaneous splenic rupture should be considered in the differential diagnosis of patients undergoing thrombolytic therapy who develop signs of hemodynamic instability.

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

10.21203/rs.3.rs-40764/v1 ◽

2020 ◽

Author(s):

Mohammadreza Mobayen ◽

Saeed Yousefi ◽

Mohammadsadegh Mousavi ◽

Amin Shafighi Anbaran

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Inflammatory Diseases ◽

Spontaneous Splenic Rupture ◽

Hematological Diseases ◽

Medical Centers ◽

Distress Symptoms ◽

Patient Reported ◽

History Of ◽

Rupture Of The Spleen

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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Frequency and causes of mortality in patients with stroke referred to Zahedan city hospital in 2016

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20180588 ◽

2018 ◽

Vol 6 (3) ◽

pp. 743 ◽

Cited By ~ 2

Author(s):

Alireza Khosravi ◽

Hamed Amirifard ◽

Fatemeh Karami

Keyword(s):

Mortality Rate ◽

Statistical Methods ◽

Cross Sectional Study ◽

City Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Common Cause ◽

Causes Of Mortality ◽

The Mean

Background: Stroke is the fifth common cause of mortality worldwide. This study was conducted with the aim of Evaluation of mortality rate and its causes in patients with stroke referred to Zahedan city hospital.Methods: This was a cross-sectional study that conducted on 320 patients with stroke. Data collected by a checklist and then analyzed by statistical methods in SPSS.19.Results: Of all patients, 59.7% were male and 40.3% were female. The mean age of patients was 63.18±13.85 years. 76% of the strokes were ischemic and 24% were hemorrhagic. The mortality rate in this study was 16.3% which was not correlated with age, gender and type of stroke. The most common cause of mortality was pneumonia aspiration with 36.5 % and then sepsis with 32.7%.Conclusions: In overall, this study showed that mortality rate was 16.3 % and the most common cause of mortality was pneumonia aspiration and sepsis.

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

BMC Surgery ◽

10.1186/s12893-020-00887-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mohammadreza Mobayen ◽

Saeed Yousefi ◽

Mohammadsadegh Mousavi ◽

Amin Shafighi Anbaran

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Inflammatory Diseases ◽

Spontaneous Splenic Rupture ◽

Vast Number ◽

Medical Centers ◽

Distress Symptoms ◽

Patient Reported ◽

History Of ◽

Rupture Of The Spleen

Abstract Background Splenic rupture is an emergency condition and a vast number 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. Case presentation 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 h 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 refer 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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