1/27. splenic rupture in a patient with acute myeloid leukemia undergoing peripheral blood stem cell transplantation.splenic rupture is a rare but well-recognized complication of hematological malignancies. Here, we present the case of a 22-year-old woman with the diagnosis of acute myeloid leukemia who was undergoing peripheral blood stem cell transplantation. On day 10 she developed a hypovolemic shock due to rupture of her spleen and went to emergency laparotomy. This is the first report of splenic rupture during peripheral blood stem cell transplantation.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
2/27. splenic rupture as a consequence of giant paraesophageal hernia.Elective surgical repair of "giant" paraesophageal hernias is recommended to prevent the potential complications of gastric volvulus, obstruction, and ischemic perforation. We report the unusual complication of splenic capsular laceration and hemorrhagic shock following forceful retching by a patient with an incarcerated paraesophageal hernia.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
3/27. [diagnosis and treatment of spleen rupture during pancreatitis]A 31-year old man was admitted for acute pancreatitis. His condition deteriorated progressively and he developed an acute anemia followed five days after admission by an hemorrhagic shock consecutive to splenic rupture. A 45-year old woman was admitted because of an acute episode of chronic pancreatitis. She improved progressively but developed eleven days after admission an hemorrhagic shock consecutive to the rupture of a subcapsular haematoma of the spleen. splenic rupture, an infrequent complication of acute or chronic pancreatitis, is responsible for anemia and hemorrhagic shock. Abdominal ultrasonography and CT scan are necessary to make the diagnosis of splenic rupture and to look for risk factors of splenic rupture, i.e. necrosis in the spleen hilium, left pancreatic pseudocyst, splenic vein thrombosis, segmental portal hypertension, splenomegaly and intrasplenic collection. When possible, embolization of the splenic artery can stop bleeding. splenectomy with distal pancreatectomy seems to be the appropriate treatment of splenic rupture.- - - - - - - - - - ranking = 3keywords = shock (Clic here for more details about this article) |
4/27. Spontaneous delayed splenic rupture--case report of a five-year interval between trauma and diagnosis.A 27-year-old white man was admitted in shock with a tender distended abdomen 5 years following significant thoraco-abdominal trauma. Immediately following resuscitation he had an emergency exploratory laparotomy because of his critical condition. At operation 3 liters of old and fresh blood were present intraperitoneally and the spleen was ruptured. The spleen was surrounded by and adherent to the omentum and adjacent viscera. splenectomy was performed and recovery was uneventful. Histologic examination of the spleen confirmed the 5-year interval between injury and rupture. Delayed splenic rupture accounts for 14% of all splenic injuries and has a high mortality. This case represents the longest reported delay between splenic trauma and delayed rupture.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
5/27. Rupture of a previously normal spleen in association with enoxaparin: An unusual cause of shock.We report the case of an adult male presenting in shock caused by spontaneous rupture of a pathologically normal spleen. One day before his presentation he had received a single subcutaneous injection of enoxaparin. This was the patient's only clearly identifiable risk factor for spontaneous splenic rupture. Nontraumatic splenic rupture should be included in the differential diagnosis of shock.- - - - - - - - - - ranking = 6keywords = shock (Clic here for more details about this article) |
6/27. Blunt abdominal trauma with delayed rupture of splenic haematoma in a haemophiliac patient.A 13-year-old haemophilia A patient presented with pain in the abdomen, 4 days after a blunt abdominal trauma. The computed tomography scan of the abdomen showed a large splenic haematoma. The patient was initially managed with factor viii replacement therapy, but 4 weeks later he had a delayed rupture of the splenic haematoma with haemoperitoneum and shock. An elective splenectomy under factor viii therapy was successfully performed.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
7/27. splenic rupture following ESWL for a pancreatic duct calculus.Extracorporeal shock wave lithotripsy (ESWL) is an established and extensively used treatment alternative for urinary calculi. It is also an established method of dealing with pancreatic duct calculi complementing endoscopic techniques in selected cases. Three reports of splenic injury following and probably caused by ESWL for urinary calculi have previously been published. We report a case of splenic rupture presenting with life-threatening hemorrhage 6 days after a single ESWL therapy session for pancreatic duct calculi.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
8/27. Management of splenic trauma in the pediatric hemophiliac patient: Case series and review of the literature.In July and August 1998, 3 patients who attend the Hemophilia Treatment Center required emergency admission to the authors' hospital for management of hemorrhagic shock caused by splenic injury. Computed tomography was used to diagnose and grade the splenic injuries, which ranged from II to IV on the organ injury scale. Two patients had Christmas disease (factor ix deficiency) and were treated with splenorrhaphy and factor ix replacement. One patient who has severe von Willebrand disease (Type 3) had grade II splenic injury that required splenectomy to secure hemostasis. The coagulopathic deficiency was aggressively treated in each patient. All patients required operative intervention with attempted splenorrhaphy. All patients survived their operative experience, and none suffered a rebleeding episode. With correction of the coagulopathy throughout the perioperative period and local hemostatic control by operative techniques, salvage procedures for splenic injury were successful for 2 of these 3 patients.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
9/27. Fatal splenic arterial aneurysmal rupture associated with chronic pancreatitis.Splenic arterial aneurysms (SAA) are rare and are usually atherosclerotic and/or related to pregnancy. Because pregnancy is the most important predisposing factor, the strong predilection of SAA for women is not surprising. The authors report a case of SAA rupture in a man with chronic pancreatitis as the predisposing factor. A 56-year-old man with abdominal pain and hematemesis was resuscitated and underwent endoscopy, but he died 18 hours later of massive hematemesis before definitive surgery could be carried out. At autopsy, there was chronic pancreatitis with fibrous adhesions tethering the tail of the pancreas, spleen, and posterior wall of the stomach together. The SAA was indented into the posterior wall of the stomach, into which it had ruptured from without. He also had alcoholic cirrhosis but no esophageal varices or conventional gastric ulcers. Other important predisposing factors such as abdominal trauma, infective endocarditis, polyarteritis nodosa, and segmental medial arteriopathy were absent. Histologic examination confirmed the rupture of the SAA. The SAA had Monckeberg medial calcinosis but little evidence of atherosclerosis. The well-documented complications of acute and chronic pancreatitis include shock, abscess, pseudocyst formation, and duodenal obstruction. This report describes the rare complication of SAA rupture, which may be fatal.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
10/27. Spontaneous rupture of a normal spleen.A 45-year-old woman was admitted with a gangrenous toe. She had a pancreatico-renal transplant for end-stage renal disease due to type I insulin dependent diabetes three years previously and had been taking immunosuppressive agents. An epidural catheter was placed to relieve the rest pain. Next day she was found to be hypotensive and tachycardic along with other features of shock. She did not have any clinical symptoms and signs initially. Urgent blood investigations were normal except for Hb of 5.0 g/dl; an ultrasound scan showed free fluid in the peritoneal cavity. Emergency laparotomy after resuscitation confirmed a massive haemoperitoneum secondary to a ruptured spleen. histology showed loss of areas of the capsule and other areas showing subcapsular haemorrhage with no underlying pathology in the spleen.- - - - - - - - - - ranking = 1keywords = shock (Clic here for more details about this article) |
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