Spontaneous Splenic Rupture Research Articles

Spontaneous splenic rupture due to Peliosis and the association with malignancy: A case series and literature review.

Isolated splenic peliosis is an extremely rare condition. The associations of splenic peliosis with various infections, medications, and conditions have unclear significance. We present three patients from the past twenty years with spontaneous splenic rupture due to peliosis, two of whom had hematologic malignancy, to draw attention to a possible correlation. A 31-year-old male with essential thrombocytopenia and antiphospholipid-antibody syndrome presented with worsening abdominal pain and hypotension. The patient denied any trauma. Computed-tomography demonstrated hemoperitoneum and splenic rupture with innumerable blood-filled splenic cysts. An uncomplicated emergency open splenectomy was performed with shed-blood reinfusion. The patient was discharged on postoperative day five. The patient developed acute myelogenous leukemia and died six years later. A 44-year-old otherwise healthy male presented with left upper-quadrant and shoulder pain without reported trauma. Computed-tomography (CT) imaging revealed splenomegaly, multiple splenic cystic lesions, and free intraperitoneal blood. A laparoscopic splenectomy, complicated by a pancreatic leak that was managed with a drain, was performed. The patient was discharged on postoperative day three and was well at 37months follow-up. A 78-year-old male with splenomegaly and chronic anemia on warfarin for atrial fibrillation presented in shock with a distended abdomen after falling from a standing height. The patient was resuscitated with two units of packed red blood cells and underwent emergent abdominal exploration. The spleen was ruptured. An open splenectomy was performed and four liters of intraperitoneal blood were evacuated. Pathology confirmed splenic peliosis and historic diffuse large B-cell lymphoma. The patient had an excellent response to chemotherapy but died 12years later. Splenic peliosis is a rare vascular phenomenon of unclear etiology. Several toxic and pharmaceutical agents have been associated with spontaneous splenic rupture in patients with peliosis. There are also a number of reported patients who were noted to have hematologic disorders, suggestive of a potential association to the pathophysiology of peliosis. Based on our clinical experience and focused literature review, it appears likely that there is a relationship between splenic peliosis and hematologic malignancy.

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.

Spontaneous Splenic Rupture: Case Report from Yekatit 12 Medical College Hospital, Addis Ababa, Ethiopia

Splenic rupture can be traumatic or non-traumatic (spontaneous). The spleen is the commonest solid organ injured in blunt abdominal injury. Spontaneous splenic rupture is rare and one cause of acute abdomen which can lead to morbidity and mortality. Among patients having spontaneous splenic rupture, majority of them have underlying splenic pathology of different causes such as hematologic, infectious, inflammatory, drugs or mechanical. In endemic area of malaria, spontaneous splenic rupture is one of fatal complication of severe malaria fortunately it is rare complication. In rare cases there may be no splenic pathology identified which is called idiopathic. The treatment of ruptured spleen is mainly splenectomy though there are cases reports of angioembolization as treatment option. Here we present a case report of 20 year old male patient who presented with diffuse abdominal pain of 3 days duration with signs of generalized peritonitis. During exploratory laparotomy, he was having ruptured spleen with blood in the peritoneum. He was managed with splenectomy and cross match transfusion after the bleeding was controlled. The patient was discharged improved after he took pentavalent vaccine. In conclusion, though spontaneous splenic rupture is rare over all there are different case reports of this condition and one has to consider it as differential diagnosis in patient who presented with acute abdomen of unclear causes and especially if the patient has underlying diseases or drugs that can affect the spleen.

Spontaneous Splenic Rupture - A Rare Complication of Cirrhosis with Portal Hypertension: A Case Report

Spontaneous rupture rupture in cirrhotic patients with portal hypertension is a rare complication; however, the incidence, etiology and risk of rupture have not been established. The diagnosis is confirmed by abdominal imaging or exploratory laparotomy and treatment is essentially surgical. We report a case of atraumatic splenic rupture in a 30-year- old woman with hepatic cirrhosis associated with splenomegaly.

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.

Atraumatic splenic rupture in COVID-19 era: case report and systematic literature review.

Atraumatic splenic rupture is a rare but life-threatening condition. The Coronavirus disease 2019 (COVID-19) is still a mysterious infection, often associated with spontaneous bleeding and coagulation disorders. Among them, a rare presentation is the atraumatic splenic rupture during SARS-CoV-2 infection. We reported the case of a COVID-19 patient that underwent splenectomy for a spontaneous splenic rupture without splenomegaly or any hematological disorders. Moreover, we reviewed the literature about this matter focusing on the hypothetical etiopathogenesis of this condition in COVID-19 patients. Twelve cases of atraumatic splenic rupture without splenomegaly were reported in ten papers. Coughing, respiratory tract infections and anticoagulant treatment were postulated as the main risk factors for the spontaneous splenic rupture. COVID-19 is still a not well-known disease with multiple clinical presentations. The spontaneous splenic rupture is uncommon in general population but this event should not be neglected in this particular subset of patients.

Simple hepatic cyst predisposing to spontaneous splenic rupture

Simple hepatic cysts are mostly asymptomatic and rarely cause any complication. Liver cysts have been reported to cause portal hypertension which is a risk factor for splenic rupture. We report a case of a woman in her 70s who died from a splenic rupture. She complained of abdominal pain one day prior to death and was subsequently found collapsed on the floor the following morning. No direct impact to the chest or abdomen or other trauma was reported prior to death. Examination showed a 55 mm simple hepatic cyst located at the porta hepatis adjacent to the hepatic portal vein bifurcation.

Gray Platelet Syndrome-Unusual Presentation with Spontaneous Splenic Rupture: A Case Report and Literature Review.

Gray platelet syndrome (GPS) is a rare hereditary hemorrhagic disorder characterized by macrothrombocytopenia and the absence of alpha-granules in platelets. Clinically, mild-to-moderate bleeding is the main manifestation, often accompanied by thrombocytopenia, splenomegaly, and myelofibrosis. Here, we present a case of a 15-year-old male patient with a history of hepatosplenomegaly, and thrombocytopenia for 8 years, who presented with sudden generalized abdominal pain. Despite initial suspicion of gastroenteritis, diagnostic imaging revealed an extensive hemoperitoneum. Subsequent genetic testing confirmed the diagnosis of GPS, which had not been previously identified. This case highlights the importance of considering inherited platelet disorders should be considered in adolescents with long-standing thrombocytopenia, and emphasizes the need for thorough evaluation in patients with suggestive symptoms.

Complement-Mediated Thrombotic Microangiopathy and Spontaneous Splenic Rupture Associated With Cytomegalovirus Infection.

This is a case report of a previously healthy female patient with complement-mediated thrombotic microangiopathy (TMA) caused by a systemic cytomegalovirus infection that was successfully treated with plasmapheresis, steroids, and parenteral valganciclovir. Complement-mediated TMA is the result of various genetic mutations leading to complement abnormalities with overactivation of alternate complement pathway in response to a triggering infection. She also had splenic rupture without splenomegaly and was managed successfully without splenectomy.

Spontaneous splenic rupture secondary to salmonella bacteraemia: a case report and review of literature

INTRODUCTION Spontaneous splenic rupture without any history of trauma is a rare and under-recognized entity in patients presenting with acute abdomen. This is a life threatening condition seen in association with various haematological malignancies, medications and blood stream infections. CASE PRESENTATION We report the case of a ninety-four-year-old male who presented to a regional Australian Hospital with abdominal pain, fever and hypotension. Imaging revealed splenic rupture. Salmonella Typhi was isolated on blood and peritoneal cultures. The patient’s Salmonella exposure was likely related to frequent consumption of raw eggs. He was managed conservatively with intravenous antibiotics to treat salmonella bacteraemia. Unfortunately, the patient died prior to discharge. DISCUSSION Salmonella bacteraemia is an uncommon cause of splenic rupture. Timely diagnosis and identification of the underlying aetiology of splenic rupture is essential for targeted management of such patients. CONCLUSION Spontaneous splenic rupture is a rare and potentially life threatening disorder which should be considered in the differential diagnosis of acute abdomen, regardless of any occurrence of trauma. Early recognition of this condition is essential to prevent the associated morbidity and mortality.

A case of splenectomy for spontaneous splenic rupture

脾破裂は外傷性と非外傷性に分けられ，非外傷性脾破裂の原因として血液疾患や悪性腫瘍，感染症などが挙げられ，極めて稀である。症例は80歳男性。左上腹部痛を訴え，近医から精査加療目的に当院に紹介となった。当院到着時，バイタルサインは安定していたが造影CTで脾被膜の連続性途絶，脾周囲，骨盤底には血腫を疑わせる液体貯留を認めた。外傷歴はなく，非外傷性脾破裂の診断で，緊急開腹脾臓摘出術を施行した。術後経過は良好で術後11日目に退院した。本症例では既往に血液疾患などは認めず，またウイルス感染を疑う臨床所見などは認めなかった。病理診断でも悪性腫瘍は否定的であり，特発性脾破裂の診断となった。特発性脾破裂に対して脾臓摘出術を施行した1例を経験したため報告する。

Spontaneous Splenic Rupture in A Non-Hodgkin Lymphoma Patient, A Rare Case Report

Splenic rupture with no history of previous trauma is known as spontaneous splenic rupture or atraumatic splenic rupture. Most patients have high mortality rates due to missed or delayed diagnosis. In this case report, a 41-year -old male patient who presented with jaundice developed a spontaneously ruptured spleen. One of the misleading clues to this patient's clinical situation was the previous free surgical and medical history with no known predisposing factors at the time of splenic rupture diagnosis.

SPONTANEOUS SPLENIC RUPTURE IN A CASE OF P. VIVAX INFECTION - A RARE CASE REPORT

Non traumatic, spontaneous splenic rupture is a rare diagnosis. It has various etiologies one of which is malarial parasite, a common endemic infection seen in India. This is a rare case report of spontaneous splenic rupture due to malaria infection, successfully managed with emergency splenectomy. High index of suspicion and early use of ultrasonography in malaria positive patients can lead to early diagnosis with signicant reduction of delay in the denitive management of patients with spontaneous splenic rupture.

Spontaneous splenic rupture as initial presentation of diffuse large B-cell lymphoma.

Spontaneous splenic rupture as initial presentation of diffuse large B-cell lymphoma.

S1895 A Case Review of Spontaneous Splenic Rupture Caused by Pancreatitis With Subsequent Peripancreatic Abscess

S1895 A Case Review of Spontaneous Splenic Rupture Caused by Pancreatitis With Subsequent Peripancreatic Abscess

Atraumatic splenic rupture in a patient after apixaban use and radiologically inserted gastrostomy – a case report

Andrius Račiūnas1 1Royal London Hospital, Barts Health NHS Trust, Ear, Nose & Throat Department, London, United Kingdom Abstract: Introduction. Atraumatic splenic rupture (ASR), also known as spontaneous splenic rupture, is a rare, potentially life-threatening condition that can be a result of infection, malignancy, inflammation, and a complication of various surgical procedures. There are not enough studies about patient characteristics, incidence rates, aetiology, and guidelines for management associated with ASR. Clinical case. A 53-year-old gentleman had a transoral robotic resection of the left tongue base/aryepiglottic fold carcinoma and level 2-4 neck dissection. Subsequently, he had a radiologically inserted gastrostomy (RIG) for his dysphagia and airway protection. Two days after RIG was inserted, the patient collapsed in the ward. Blood tests were done and showed a severe haemoglobin level drop from 123 g/L to 73 g/L. Computer Tomography (CT) of the abdomen showed splenic bleeding. He had emergency laparotomy with splenectomy which showed no signs of traumatic spleen rupture secondary to RIG insertion. A histopathology sample taken in theatre showed no pathological changes in the spleen. There were no other causes apart from apixaban which was stopped before the procedure and resumed 24 hours after RIG insertion. Conclusion. ASR is a rare event in healthcare and the symptoms are not specific. Abdominal pain on the left side that can spread to the shoulder, a decrease in haemoglobin level, and signs of haemorrhagic shock are all possible signs of bleeding in the spleen. Anticoagulant therapies such as apixaban, rivaroxaban, direct-acting oral anticoagulants (DOAC), and dabigatran are linked to instances of ASR. Keywords. Atraumatic splenic rupture, splenectomy, radiologically inserted gastrostomy, apixaban.

Spontaneous splenic rupture as the first clinical manifestation of Niemann-Pick disease type B: A case report and review of the literature

Splenomegaly is the most common phenotype for Niemann-Pick disease type B (NPD-B), an autosomal recessive lipid storage disease caused by deficiency of the lysosomal enzyme acid sphingomyelinase. Although a spleen of massive volume is common in NPD-B, splenic rupture in this disease is rarely reported. We describe a patient with NPD-B who initially presented with spontaneous splenic rupture. Microscopic examination of the spleen specimen revealed expansion of the red pulp by abundant foamy histiocytes. A literature review revealed that splenic rupture resulting from latent splenomegaly may occur in middle adulthood in a mild form of NPD-B associated with SMPD1 variants of lower pathogenicity. We suggest that unexplained splenomegaly or splenic rupture should raise the possibility of a lysosomal storage disease, including NPD. For patients with NPD-B, spleen size should be evaluated periodically, and the risk of splenic rupture should always be considered.

Chronic lymphocytic leukemia, a rare cause of spontaneous rupture of the spleen.

IntroductionSpleen Spontaneous Rupture SRS is a rare phenomenon in which the spleen ruptures without associated trauma. This pathology is rarely caused by Chronic Lymphocytic Leukemia.Presentation of the caseWe present a case of a 59-year-old male patient with chronic Lymphocytic Leukemia, who was admitted with an acute abdomen whose clinical and paraclinical examinations revealed a spleen spontaneous rupture. The treatment consisted of a splenectomy.DiscussionSpontaneous spleen rupture was first described by Rokitansky in 1861 and mentioned in many cases since, the common causes of non-traumatic Splenic rupture include myeloproliferative diseases, vasculitis, and infections. However, Chronic Lymphocytic Leukemia (CLL) remains an obscure cause of splenic rupture that requires unique attention. The diagnosis of splenic rupture should be considered in all patients with hematologic malignancies presenting with abrupt onset of abdominal pain, hemodynamic instability, or acute anemia. The choice between conservative treatment and splenectomy depends on different variables: the etiology of the SRS, the hemodynamic stability, the amount of packed red blood cells transfused. Thus, an interventional approach can be advocated for a spontaneous splenic rupture over nonoperative management. Splenic embolization can provide patients with the advantages of both operative splenectomy and conservative management. The mortality rate from SRS is 12.2 %. Neoplastic pathologies were most significantly associated with fatal outcomes.ConclusionThe high mortality rate seems to be mainly related to the delayed diagnosis and/or the severity of the underlying pathology. Given its seriousness, it requires a rapid diagnosis and adapted management.

Spontaneous Splenic Rupture in Plasmodium Vivax Malaria

Splenomegaly is one of the common complications of malaria most commonly associated with Plasmodium Vivax. Due to inadequate treatment, spleen can harbor parasite, which causes recurrent infection leading to splenomegaly and splenic rupture. Spleen is more prone to rupture in acute phase of infection. The exact mechanism of splenic rupture is still unknown but trauma, pressure of abdominal muscles on spleen due to sneezing and coughing plays important rule. Spontaneous splenic rupture although very rare in normal sized spleen, as in case presented here, is life-threatening complication. Therefore, early diagnosis and management plays important role in saving life.

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.