Case Of Spontaneous Splenic Rupture Research Articles

EGS P35 Spontaneous rupture of the spleen: Is it caused by COVID?

Abstract Background Spontaneous rupture of spleen (SSR) is rare but known entity in patients with underlying pathology of spleen1. However, there are reports of spontaneous splenic rupture in patients with no known underlying pathology2. With the onset of COVID pandemic, rising incidence of various disease conditions were linked to either COVID infection or vaccine. Similarly, we are presenting three cases of spontaneous splenic rupture managed by our team in last one year which could be attributed to COVID infection or vaccine. Methods The data of all the patients admitted in an urban tertiary Upper GI Unit with spontaneous splenic rupture in last one year was collected prospectively from online data storage software called Flex Prod. The data was extracted from this software and analysed retrospectively maintaining patient confidentiality throughout the process. Results Three patients of spontaneous splenic rupture received treatment post COVID in this trust. 2 out of 3 patients had COVID infection in the past and all three had received vaccine. Two patients presented to A&E with hypotension and tachycardia, were appropriately resuscitated, and then underwent successful angio-embolization. Both were monitored in the critical care in the periprocedural period and subsequently transferred to the ward. Third patient presented to A/E with upper abdominal pain and tachycardia, CT scan showed high grade rupture of spleen with low haemoglobin. Hence, angioembolization was carried out, patient recovered well postoperatively and was discharged. Conclusions Spontaneous rupture of spleen is rare but potentially life-threatening condition more common in patients with underlying spleen pathology3. The etiology of SSR is uncertain, however, recent case reports of patients with COVID presenting with spontaneous splenic rupture4 has led to increased interest in COVID as a cause of SSR in the post COVID era.

Spontaneous Splenic Rupture during Acute Pancreatitis

Non-traumatic splenic rupture is a rare event that can occur in acute pancreatitis. Its exact etiology remains undefined. It constitutes a diagnostic problem because of the low specificity of the clinical characteristics. Imaging plays an important role in diagnosis and follow-up. Treatment should be carried out promptly, taking into account the hemodynamic status of the patient in order to avoid death. We report a case of spontaneous splenic rupture in an elderly patient with Balthazar's stage E acute pancreatitis to educate clinicians and radiologists about this underestimated emergency.

When the Spleen Breaks: A Rare Case of Spontaneous Splenic Rupture and the Diagnostic Significance of CT Scan

Purpose: This case report aims to discuss the rare occurrence of spontaneous splenic rupture and the utility of CT scans in its diagnosis and management. Presentation of Case: A 58-year-old chronic smoker presented to the emergency department with sudden-onset abdominal pain. He was diagnosed with splenic rupture based on clinical presentation and imaging findings, including an enlarged spleen and abdominal fluid on CT scan. The patient underwent splenectomy, with histological examination confirming the diagnosis. Discussion: CT scan is a commonly used imaging technique in the diagnosis of splenic masses, providing a high resolution, cross-sectional view of the spleen and surrounding structures. The use of contrast agents enhances the differentiation between vascular and non-vascular lesions and improves the accuracy of diagnosis. Other imaging techniques such as ultrasound, MRI, and PET-CT may also be used. The treatment of splenic masses depends on the underlying etiology and the clinical status of the patient. Conclusion: The CT scan findings in this case suggest a splenic mass, which was confirmed to be a decapsulated spleen on histological examination after splenectomy. The use of imaging techniques such as CT scan is important in the diagnosis and management of splenic masses, aiding in preoperative planning and postoperative monitoring. Postoperative management of splenic rupture typically involves pain control, antibiotic therapy, and lifelong prophylactic antibiotics and vaccinations to reduce the risk of infection. This case report discusses a rare case of spontaneous splenic rupture and highlights the diagnostic and management utility of CT scans. The patient, a 58-year-old chronic smoker.

Zriedkavá príčina spontánneho krvácania sleziny: kazuistika a prehľad literatúry

Rupture of the spleen is a serious medical condition manifesting as a sudden abdominal event, potentially life-threatening. Spontaneous spleen rupture is a rare condition. Atraumatic rupture of the spleen is a very unlikely condition. Risk factors include splenomegaly, hemato-oncological diseases, and infections, such as malaria or infectious mononucleosis. Extremely rare is splenic rupture described in autoimmune disease or vasculitis. There has been no reported case of spontaneous splenic rupture as a first manifestation of Churg- Strauss syndrome so far.

A Case of Spontaneous Splenic Rupture in Newborn

Splenic rupture is rarely seen in neonates these days. This is because traumatic deliveries rarely occur. However rarely splenic rupture can take place spontaneously and can present with life threatening haemorrhagic shock. A case of spontaneous and delayed rupture of the spleen in a neonate that was managed with conservative approach with good outcome has been described in this case report.

A Case of Spontaneous Splenic Rupture Successfully Treated by Transcatheter Embolization

A Case of Spontaneous Splenic Rupture Successfully Treated by Transcatheter Embolization

Spontaneous Rupture of Spleen in a Pregnant Armenian Woman with Favourable Pregnancy Outcome: Case Report

Background: Spontaneous or traumatic rupture of spleen in pregnancy is a rare event with catastrophic consequences. This report presents a case of spontaneous splenic rupture of a pregnant woman with thrombophilia in complicated somatic history and successful cesarean section with maternal and infant survival. Case: A 28-year-old Armenian woman at 35 weeks of gestation presented to the Emergency Department at “Erebouni” medical center in Yerevan, Armenia with sharp pain in the epigastric region, general weakness and worsening condition. The patient was immediately transferred to the operating room. All clinical-laboratory examinations were urgently carried out, the fetus condition began to be assessed under the control of the CT. She was in obvious distress with blood pressure of 90/50 mm Hg and a pulse rate of 80 - 70 beats per minute. Abdominal ultrasound confirmed free fluid in the peritoneal cavity. Cesarean section was performed on the lower segment of the uterus. A live premature female infant was born weighing 2580 g, height 48 cm, and with an Apgar score of 7 - 8 points. Then the integrity of the uterus was restored. Abdominal rehabilitation was performed, there were about 1000 ml of blood loss and continuous internal bleeding. Doctors found splenic ruptures around the perineum. Lower middle laparotomy, splenectomy, abdominal rehabilitation, drainage were performed. Conclusion: This case illustrates the need to consider ruptured spleen as part of differential diagnosis of hemoperitoneum in pregnant women. Immediate surgical intervention is needed to ensure survival of mother and fetus.

A Rare Case of Spontaneous Splenic Rupture in Refractory Mantle Cell Lymphoma.

A Rare Case of Spontaneous Splenic Rupture in Refractory Mantle Cell Lymphoma.

Spontaneous splenic rupture 1 week after laparoscopic appendectomy due to acute appendicitis.

Spontaneous splenic rupture is a rare entity that requires high index of suspicion for diagnosis. Usually, it occurs due to underlying pathology that could be inflammatory, neoplastic or infectious. However, there are also cases of spontaneous splenic rupture in a normal-sized spleen without obvious pathologic process. In our case, the patient suffered a spontaneous splenic rupture 1 week after laparoscopic appendectomy due to acute appendicitis. Histopathologic examination revealed a normal-sized spleen without any obvious pathology. In our patient, we did not found any explanation for a spontaneous splenic rupture, besides her primary inflammatory condition.

Atraumatic Splenic Hemorrhage as a Rare Complication of Pancreatitis: Case Report and Literature Review.

Splenic hemorrhage (hematoma and rupture) is a rare complication of pancreatitis. In this article, we present a rare case of spontaneous splenic rupture as a complication of acute pancreatitis. A literature review was also completed to describe the patient characteristics, associated pancreatitis etiology, clinical presentations, risk factors, diagnostic and treatment modalities, and outcomes.

A rare cause of hypersplenism; splenic amyloidosis induced by familial mediterranean fever

Background: Familial Mediterranean Fever (FMF) is an inflammatory disease characterized by fever and serositis attacks. The most important complication of the disease is the development of AA type amyloidosis. Amyloid most often accumulates in the kidney, liver, spleen and heart. Splenomegaly may be seen secondary to inflammatory response without developing amyloidosis in FMF patients. Although splenic amyloidosis has an asymptomatic nature but in the literature several cases of spontaneous splenic rupture due to splenic amyloidosis have been reported. There are no reported cases of hypersplenism due to AA type amyloidosis in the literature so that our case has importance in this respect. Case summary: A 30-year-old female patient with diagnosis of FMF and proteinuria for 3 years was admitted to the nephrology outpatient clinic because of weakness, palpitation and swelling of the legs. She had anemia and thrombocytopenia. She had a recent history of hospitalization due to frequent erythrocyte transfusion requirements. Bone marrow related diseases and immunologic causes were excluded during the evaluation of bicytopenia. Patients history revealed that she had amyloid deposition in kidney. The patient's need for frequent blood transfusion was attributed to hypersplenism. Splenectomy was performed and amyloid deposition was detected in the spleen. After splenectomy, hemoglobin and platelet counts were increased. Conclusion: We present a case with hypersplenism secondary to AA type amyloidosis and who were treated with splenectomy. If cytopenia and splenomegaly were detected in FMF patients then hypersplenism must be considered and splenectomy must be kept in mind for the treatment.

Sudden spleen rupture in a Plasmodium vivax-infected patient undergoing malaria treatment

BackgroundSplenomegaly is one of the most common features of malaria. However, spontaneous splenic rupture, although unusual, represents a severe complication often leading to death. It is mostly seen in acute infection and primary attack, and it is most commonly associated with Plasmodium vivax. Here, a case of spontaneous splenic rupture diagnosed with a portable ultrasound apparatus shortly after starting treatment and with recurrent parasitaemia after splenectomy, is reported.Case descriptionIn November 2015, a 45-year-old Brazilian man presented to the hospital in Manaus with fever, headache and myalgia. He was diagnosed with P. vivax malaria and, after a normal G6PD test, he started treatment with chloroquine and primaquine and was discharged. Two days later, he went back to the hospital with abdominal pain, dyspnea, dry cough, pallor, oliguria and fever. Using a portable ultrasound, he was diagnosed of rupture of the spleen, which was removed by emergency surgery. After this episode, he suffered two more malaria episodes with high parasitaemia at approximately 2-month intervals. DNA from different portions of the spleen was extracted and a qualitative PCR was performed to detect P. vivax.ConclusionsThe splenic rupture suffered by this patient occurred 2 days after starting the treatment. Having a portable ultrasound apparatus may have saved the patient’s life, as it revealed a haemorrhage needing an urgent surgery. Parasites were detected by PCR in the extracted spleen. This patient suffered two more vivax malaria diagnosed episodes in spite of receiving and completing treatment with chloroquine and primaquine for each clinical attack. Splenic rupture during acute malaria is uncommon, but it is likely underdiagnosed and underreported, because the lack of means and equipment hinders diagnostic confirmation, especially in endemic areas.

Spontaneous Splenic Rupture in the Early Postoperative Period to After Lobectomy.

Spontaneous splenic rupture is a quite rare entity that may develop secondary to some special situations (lymphoma, post-abdominal surgey etc). In the literature, the case of a patient has been reported following thoracic surgery. In a patient who had undergone right upper lobectomy for pulmonary carcinoma, signs of acute abdomen and low levels in the hemogram were detected on the fifth postoperative day; therefore, the patient underwent further investigations. A radiological evaluation revealed splenic rupture, and the patient was operated on. A case is presented that may be fatal and requires emergency response and that has to be kept in mind, although it is extremely rare. A case of spontaneous splenic rupture has been presented that may be fatal and requires emergency response; this should be kept in mind, although it is extremely rare.

Spontaneous splenic rupture in an acute leukemia patient with splenic tuberculosis: A case report

Spontaneous splenic rupture, also referred to as atraumatic splenic rupture, is a rare but life-threatening emergency condition. Without timely diagnosis and treatment, the mortality rate of splenic rupture approaches 100%. The etiology of atraumatic splenic rupture varies; it is reportedly associated with neoplasms or splenic infection, but is rarely encountered in patients with both conditions. We herein report the case of a 58-year-old male patient with acute myeloid leukemia (AML) complicated by splenic tuberculosis (TB), who presented with spontaneous rupture of the spleen. Pathological examination of the resected spleen revealed multifocal granulomatosis with caseous necrosis. However, with timely diagnosis and surgical intervention, the patient recovered successfully and is currently on consolidation therapy. To the best of our knowledge, this is the first case of spontaneous splenic rupture in AML with splenic TB. The relevant literature on spontaneous splenic rupture was also reviewed and the potential etiology and treatment were discussed.

Comparison of the Trachway video intubating stylet and Macintosh laryngoscope for endotracheal intubation. Preliminary data

<dm:abstracts xmlns:dm="http://www.elsevier.com/xml/dm/dtd"><ce:abstract xmlns:ce="http://www.elsevier.com/xml/common/dtd" id="ab0005" xml:lang="en" view="all" class="author"><ce:section-title id="st0005">Abstract</ce:section-title><ce:abstract-sec id="as0005" view="all"><ce:simple-para id="sp0020" view="all">We describe a case of spontaneous splenic rupture in a 74<ce:hsp sp="0.25"/>year old patient with recently diagnosed undifferentiated lymphoproliferative disorder who presented to the ED complaining of persistent abdominal pain after a recent “24<ce:hsp sp="0.25"/>hour virus” consisting of nausea and vomiting. She denied any history of falls, trauma, or injuries. On exam, the patient's abdomen was distended with rebound and diffuse tenderness to palpation, but she was otherwise stable.</ce:simple-para><ce:simple-para id="sp0025" view="all">Our patient experienced a splenic rupture secondary to splenomegaly, with a minor inciting event, thought to be vomiting. Spontaneous splenic rupture is rare, but two things about this case could explain the event: history of hematologic malignancy and emesis. It is unclear if the rupture occurred due to the abnormal spleen secondary to malignancy, the force of vomiting, or as a result of these two factors combined. While this case clearly is not a spontaneous rupture of a normal spleen, it does qualify as a spontaneous rupture of a pathologic spleen, something that is a rare occurrence and, therefore, not something that is usually high in the differential diagnosis of patients who present with these symptoms.</ce:simple-para><ce:simple-para id="sp0030" view="all">Our patient presented with the fairly routine complaint of abdominal pain and an apparent recent acute viral gastritis with emesis. With this presentation and somewhat vague history of lymphoma, this case represents an unusual finding of nonspecific abdominal pain. It serves to remind ED physicians to maintain a high suspicion for unusual intra-abdominal pathology even in hemodynamically stable patients with common presentations.</ce:simple-para></ce:abstract-sec></ce:abstract></dm:abstracts>

Spontaneous splenic rupture following stem cell mobilization with G-CSF and plerixafor in AL amyloidosis

BackgroundAL amyloidosis is a rare plasma cell dyscrasia with multiorgan involvement. Good risk patients are candidate to high dose chemotherapy and autologous stem cell transplantation. However both transplantation and stem cell collection entail significant risk in such patients. Plerixafor is a novel mobilizing agent approved for use in “poor mobilizer” patients with lymphoma and multiple myeloma; experience in systemic amyloidosis patients is limited. Case ReportWe describe a case of spontaneous splenic rupture following administration of G-CSF and plerixafor in a patient with AL amyloidosis who previously underwent heart transplantation due to amyloid heart involvement. Results and ConclusionThis is the first report of spontaneous splenic rupture following stem cell mobilization with G-CSF and plerixafor in AL amyloidosis. The role of plerixafor has to be established. AL amyloidosis patients undergoing stem cell mobilization need careful monitoring of signs and symptoms of spontaneous splenic rupture.

Atraumatic splenic rupture from Babesia: A disease of the otherwise healthy patient

Babesiosis, an infection caused by the protozoan Babesia microti and transmitted by the Ixodes scapularis tick, is commonly described in the literature with an approximate incidence of 1000 cases per year (Herwaldt et al., 2012). Infections in North America occur most frequently during the spring and summer months in the Northeastern and Midwestern United States. Babesia can cause a wide spectrum of clinical manifestations ranging from a self-limited febrile illness or mild anemia to severe illness causing acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC) and multisystem organ failure. Severe illness most commonly occurs in elderly, immunocompromised, or asplenic patients (Vannier and Krause, 2012). Splenic rupture has been generally described as a complication of severe illness secondary to babesiosis. We describe a case of spontaneous splenic rupture in an otherwise healthy woman that required emergent splenectomy. Recent case reports suggest that splenic rupture occurs in people without known risk factors for severe babesiosis. Physicians should be aware of this acute presentation in otherwise healthy individuals.

A case of spontaneous splenic rupture in pregnancy

The article provides an observation case of spontaneous splenic rupture in 33/34 weeks of pregnancy. The patient was under active-expectant management, because of premature rupture of membranes at term of 33 weeks. Suddenly, against a background of well-being, emerged clinical signs of massive intra-abdominal bleeding. During the revision of the abdominal cavity the rupture of the capsule of the spleen was detect. Cesarean section and splenectomy were performed. The postoperative period was uncomplicated, the patient was discharged home with the baby.

A Case of Spontaneous Splenic Rupture Treated with a Laparoscopic Splenectomy

A Case of Spontaneous Splenic Rupture Treated with a Laparoscopic Splenectomy

Spontaneous splenic rupture in a patient with acute promyelocytic leukaemia during induction chemotherapy

Acute promyelocytic leukaemia (APL) is a subtype of acute myeloid leukaemia with high curability rates. However, it is often accompanied by severe coagulopathy and bleeding risk and thus represents a potentially fatal haematological emergency requiring immediate treatment. Spontaneous splenic rupture is a rare event in all haematological malignancies. Only two clinical cases have been described so far in a setting of APL. We report a patient with APL without preceding splenomegaly who underwent urgent splenectomy for spontaneously occurring splenic rupture during induction chemotherapy. After surgery the patient completed induction chemotherapy and achieved complete remission. This is the second case of spontaneous splenic rupture without preceding splenomegaly in a patient with APL during induction chemotherapy described so far. Our case demonstrates that emergent splenectomy can be lifesaving even in the unfavourable condition of patient with severe immune deficiency.