A CASE OF SPONTANEOUS SPLENIC RUPTURE ASSOCIATED WITH A CHRONIC MYELOPROLIFERATIVE DISORDER

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  • 慢性骨髄増殖性疾患に併存した脾破裂の１例

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Abstract

An 82-year-old woman with a two-day history of left back pain of unknown cause, had an abdominal ultrasound study which revealed no particular abnormalities. However, she developed nausea and appetite loss ; repeat abdominal CT scan suggested rupture of the spleen. She was referred for emergency surgery. During laparotomy, about 1,000 ml of bloody ascites was found, as well as an enlarged spleen (20×11×5 cm), a ruptured capsule, and a hematoma undex the capsule. Intraabdominal hemorrhage due to splenic rupture was diagnosed, and a splenectomy was done. Based on the hematology results a coexistent hematological disorder was suspected. On bone marrow biopsy, chronic myeloproliferative disorder (CMPD) was diagnosed (Philadelphia chromosome negative).<BR>There are occassional reports of spontaneous splenic rupture. However, spontaneous splenic rupture with CMPD is rare ; this case is only the fifth reported in the Japanese literature. Our paper presents this extremely rare case along with a review of the literature.

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