Rupture of the spleen and liver in the newborn: A report of the first survivor and a review of the literature

Abstract

T HE F O L L O W I N G R E P O R T of the youngest patient to undergo splenectomy and the only survivor of neonatal rupture of both spleen and liver emphasizes the need for prompt diagnosis and surgical intervention to afford successful management of this curable neonatal problem. Diagnosis during life and successful repair of rupture of the liver or spleen in the newborn is rare. More autopsy diagnoses are reported t 3 of this unfortunate complication of delivery than are diagnoses of surviving cases)'4'5 Potter's series I of 2000 fetal and neonatal deaths includes 28 patients with traumatic rupture of abdominal viscera, and 24 of these were rupture of the liver. Gruenwald 3 reported a series of 121 autopsies on newborns of whom five had rupture of the liver, one had rupture of the spleen, and two had rupture of both organs. Sieber 2 reported three deaths in newborns from rupture of the spleen and three survivors. All three survivors had splenectomies between the ages of 36 and 72 hr. Eraklis 5 reported two patients who had splenic rupture and one who had laceration of the liver (age 2 days). Arden 4 reported a 2-day-old infant who underwent laparotomy and successful repair of the tear in the liver substance.