A CASE OF SPONTANEOUS SPLENIC RUPTURE

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  • SAKAMOTO Teruhisa
    Department of Surgery, National Hospital Organization Hamada Medical Center
  • HONJO Soichiro
    Department of Surgery, National Hospital Organization Hamada Medical Center
  • GOMYO Yoshihito
    Department of Surgery, National Hospital Organization Hamada Medical Center
  • KURISU Yasuro
    Department of Surgery, National Hospital Organization Hamada Medical Center
  • IWANAGA Yukio
    Department of Surgery, National Hospital Organization Hamada Medical Center
  • NAGASAKI Makoto
    Department of Clinical Laboratory, National Hospital Organization Hamada Medical Center

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  • 特発性脾破裂の１例

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Abstract

We present a case of spontaneous splenic rupture which might occur due to chronic pancreatitis in the background.<br>A man in his forties was seen at the emergency clinic in our hospital because of abrupt onset of lower abdominal pain. Abdominal CT scan showed multiple low-density areas in the spleen and abdominal bleeding, as well as a cystic lesion at the pancreatic tail. Intraabdominal bleeding due to rupture of a splenic tumor was diagnosed and an emergency operation was performed. There were 2,600ml of hemorrhage and clots in the abdominal cavity. The spleen had swelled up and a rupture appeared at the lower pole. The pancreas macroscopically revealed findings of chronic pancreatitis. We removed the spleen attached with the wall of the cyst at the pancreas tail. The preparation and section of the removed material disclosed only hematomas in various sizes. Histopathological studies showed prominent inflammation at the splenic hilus and capsulitis in the entire spleen ; no tumorous lesions were detected. There was no previous history of trauma. Thus we diagnosed the case as spontaneous splenic rupture due to chronic pancreatitis which might involve the spleen.<br>Considering a possible occurrence of sepsis after splenectomy, it may be desirable to preserve the spleen if it is possible, and then splenectomy is added thereafter when a splenic tumor is actually diagnosed.

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