Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases.

Jian Liu,Fei Li,Ang Li,Chunqing Liu,Yanyu Feng

doi:10.1155/2019/5827694

Abstract

Atraumatic splenic rupture (ASR) is rare but life threatening. In this study, we retrospectively described our experience on the diagnosis and treatment of 8 patients (male: 6; female: 2; mean age: 49.6) with ASR. ASR accounted for 3.2% (8/251) of the splenic ruptures. The clinical presentation of ASR was similar to traumatic splenic rupture (TSR). The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. According to the classification of the American Association for the Surgery of Trauma (AAST), 2 cases were classified as grade II splenic ruptures, 4 cases were classified as grade III ruptures, 1 case was classified as grade IV rupture, and 1 case was not classified. All the spleens became swollen, and hematomas were observed in 6 patients. Total splenectomy was recommended in most cases. At least 62.5% (5/8) of the patients with 7 etiological factors belonged to “atraumatic-pathological splenic rupture.” Local inflammation and cancer were the most common etiological factors.

Highlights

Spleen rupture is mostly caused by trauma
In some rare cases, it occurs without obvious trauma, which is called atraumatic splenic rupture (ASR) or spontaneous splenic rupture
We propose that as long as the hemodynamic status is stable, contrast-enhanced computed tomography (CECT) is necessary for patients with suspicious ASR

Summary

Introduction

Spleen rupture is mostly caused by trauma. In some rare cases, it occurs without obvious trauma, which is called atraumatic splenic rupture (ASR) or spontaneous splenic rupture. ASR is often life threatening due to the delay of diagnosis and treatment. ASR is uncommon, and little is known about its characteristics. There is still a lack of related guidelines or a standard of diagnosis and treatment for ASR. We described the characteristics of ASR patients from two university teaching hospitals with the goal of increasing the knowledge of ASR, especially its underlying etiological factors, diagnosis, and management methods

Methods

Discussion

Conclusion