腎梗塞を合併した外傷性脾破裂の1例

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  • A CASE OF TRAUMATIC RUPTURE OF THE SPLEEN ACCOMPANIED WITH RENAL INFARCTION

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While we sometimes encounter traumatic rupture of the spleen, renal infarction is very rarely accompanied in these cases. This time we experienced a patient emergently operated on for traumatic rupture of the spleen due to a traffic accident who was found to be associated with renal infarction in postoperative course. 17-year-old man was admitted to the hospital because of abdominal blunt injury by the traffic accident. On admission his blood pressure was low and there were distention, severe tenderness and signs of peritoneal irritation in the entire abdomen. Intraperitoneal bleeding was suspected by abdominal CT scanning that revealed fluid retention. Emergency operation was carried out. Because intraoperative findings revealed deep laceration into the parenchyma of the spleen, splenectomy was performed. No injury of the left kidney and no retroperitoneal bleeding were seen, and we finished this operation. Postoperative course was uneventful, but the left kidney tended to be atrophic by postoperative abdominal CT scanning. Angiography revealed occlusion of the left renal artery. But we did not performe total nephrectomy of the left kidney, because renal hypertension in this case was not manifested. The patient is strictly followed up on an ambulant basis.

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