RESUMEN
Diagnostic routine and knowledge about the therapy regimes of infectious diseases like malaria gain in importance due to globalization, global warming, and increasing numbers of refugees. We report a case of a 66-year-old patient who presented with severe abdominal pain, most prominent in the left upper abdomen. He was recently hospitalized with severe falciparum malaria, diagnosed after returning from a trip around the world. Upon readmission, laboratory results showed post-artesunate delayed hemolysis. The ultrasound examination was highly suspicious of splenic rupture, confirmed by the immediately performed CT scan. In this case, the prompt diagnosis allowed the initiation of adequate conservative therapy including intensive care monitoring and hemodynamic stabilization.
Asunto(s)
Rotura del Bazo , Humanos , Anciano , Rotura del Bazo/etiología , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/terapia , Masculino , Malaria Falciparum/diagnóstico , Malaria Falciparum/complicaciones , Diagnóstico Diferencial , Artesunato/uso terapéutico , Tomografía Computarizada por Rayos X , Ultrasonografía , Viaje , Resultado del Tratamiento , Antimaláricos/uso terapéutico , Rotura EspontáneaRESUMEN
Hematopoietic hormones such as granulocyte-colony stimulating factors are commonly used prevent neutropenia in patients undergoing chemotherapy and to prepare patients for bone marrow donations. In rare cases, splenic injury can result from exposure to this medication. We present the case of a 30-year-old man who presented to the emergency department the day after a bone marrow donation procedure complaining of severe, acute onset left upper quadrant abdominal pain, radiating to the shoulder. Neither the patient nor his family reported any abdominal trauma prior to or following the marrow donation procedure. An initial bedside ultrasound examination was positive for peritoneal fluid and distortion of the normal splenic architecture, raising suspicion for possible intraabdominal or splenic injury. An emergent confirmatory CT with contrast of the abdomen confirmed the initial ultrasound examination suspicion of an atraumatic splenic rupture and with evidence of venous bleeding but without active arterial extravasation. An emergent trauma surgery consultation was placed, and he underwent embolization with an uneventful recovery. This case report highlights the need for a high index of suspicion for atraumatic splenic rupture in patients exposed to these types of granulocyte-colony stimulating factors.
Asunto(s)
Factor Estimulante de Colonias de Granulocitos , Rotura del Bazo , Humanos , Masculino , Rotura del Bazo/inducido químicamente , Rotura del Bazo/etiología , Rotura del Bazo/diagnóstico por imagen , Adulto , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Tomografía Computarizada por Rayos X , Embolización Terapéutica/métodos , UltrasonografíaAsunto(s)
Pancreatitis , Rotura del Bazo , Humanos , Rotura del Bazo/etiología , Rotura del Bazo/cirugía , Rotura del Bazo/diagnóstico por imagen , Pancreatitis/etiología , Pancreatitis/cirugía , Masculino , Páncreas/lesiones , Páncreas/cirugía , Páncreas/diagnóstico por imagen , Bazo/lesiones , Bazo/diagnóstico por imagen , Persona de Mediana Edad , Femenino , Riesgo , AdultoRESUMEN
Splenic rupture in a neonate is a rare but potentially fatal condition that may trigger evaluation for child abuse. It is a diagnosis of exclusion that has been reported in the surgical literature but may be underrecognized by pediatric radiologists. We report a case of a newborn with an unremarkable prenatal, delivery, and nursery course who presented with anemia, abdominal distension, and lethargy. Abdominal ultrasound with Doppler and computed tomography (CT) of the head, cervical spine, chest, abdomen, and pelvis without contrast showed findings of splenic rupture and anoxic brain injury. An extensive workup for traumatic, infectious, coagulopathic, and congenital etiologies was unrevealing, leading to a presumptive diagnosis of spontaneous splenic rupture in a neonate.
Asunto(s)
Rotura del Bazo , Recién Nacido , Niño , Humanos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/cirugía , Tomografía Computarizada por Rayos X/efectos adversos , Ultrasonografía , Rotura Espontánea/complicacionesRESUMEN
Little is known about iatrogenic splenic injury (SI) as an adverse event after colonoscopy. SI is sometimes fatal because of hemorrhaging. We herein report a man who developed SI after colonoscopy. He recovered conservatively. His history of left hydronephrosis and insertion with a maximally stiffened scope were suspected as possible risk factors. Endoscopists should consider the possibility of SI when they encounter patients suffering from left-sided abdominal pain after colonoscopy. Careful interview concerning the medical history and gentle maneuvering around the splenic flexure can help avoid SI.
Asunto(s)
Rotura del Bazo , Masculino , Humanos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Esplenectomía/efectos adversos , Hemorragia/etiología , Colonoscopía/efectos adversosRESUMEN
Atraumatic splenic rupture (ASR) is a rare but life-threatening condition. Several underlying pathologies have been associated with a splenic rupture in the absence of trauma, most often malignant-haematological disorders, viral infections or local inflammatory disorders. The management of ASR is similar to traumatic splenic rupture and includes early risk stratification of patients to determine those eligible for non-operative treatment versus those who need immediate surgical intervention. In this report, we discuss a rare case of a non-operatively managed ASR in an otherwise healthy young patient with SARS-CoV-2 as the likely aetiology. The multisystemic nature of the ongoing novel COVID-19 is evident, but not all manifestations are yet known. This case report underlines the challenge for physicians in terms of recognising and treating emergent complications of this new disease.
Asunto(s)
COVID-19 , Rotura del Bazo , Humanos , COVID-19/complicaciones , SARS-CoV-2 , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Rotura del Bazo/cirugía , Esplenectomía/efectos adversos , Rotura Espontánea/etiologíaAsunto(s)
Embarazo Ectópico , Rotura del Bazo , Embarazo , Femenino , Humanos , Embarazo Ectópico/diagnóstico por imagen , Embarazo Ectópico/etiología , Embarazo Ectópico/cirugía , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Rotura del Bazo/cirugía , Rotura Espontánea/etiologíaRESUMEN
Dengue fever is one of the most frequent arboviral diseases in the world. Dengue is known to cause myocarditis, hepatitis, and neurological illustrations but one of the established presentations is leakage of plasma resulting in circulatory failure. Spontaneous rupture of the spleen is one of the most infrequent but known outcome of dengue fever which has been reported from time to time in literature. We present, here, the case of a 50-year-old patient who developed this condition during dengue fever and was managed in our department successfully. This complication must be kept in mind while treating any case of dengue fever so that it can be avoided or if not then treated timely.
Asunto(s)
Dengue , Dengue Grave , Rotura del Bazo , Humanos , Persona de Mediana Edad , Esplenectomía/efectos adversos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Rotura del Bazo/cirugía , Dengue/complicaciones , Dengue Grave/complicaciones , Dengue Grave/terapia , Rotura Espontánea/etiologíaRESUMEN
Splenic rupture following colonoscopy (SRFC) is a rare complication and can have associated mortality if left undiagnosed. Most of the cases reported have been managed operatively. Here, we present a case of a 75-year-old-female who underwent conservative management for SRFC. Splenic rupture should remain a differential in patients presenting with abdominal pain, syncope, and hypotension following colonoscopy. Decisions regarding operative versus conservative management should be guided by the patient's clinical status, hemodynamics, and available resources.
Asunto(s)
Hipotensión , Rotura del Bazo , Humanos , Femenino , Anciano , Esplenectomía/efectos adversos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Colonoscopía/efectos adversos , SíncopeRESUMEN
Atraumatic splenic rupture is a rare complication of acute and chronic pancreatitis. It arises due to its anatomical proximity to the pancreas, for instance, due to erosion of large pseudocysts or walled-of-necrosis (WON).Following we describe the case of a 62-year-old woman who presented for further diagnostics and treatment of acute pancreatitis with the development of large walled-of necrosis (WON) in the pancreatic corpus and tail. During the course, the patient developed a hemorrhagic shock. An emergency computer tomography (CT) of the abdomen revealed a ruptured spleen with a large capsular hematoma with no evidence of active bleeding. In contrast to previous published case reports, our treatment was exclusively minimal-invasive: by radiological guided embolization of the splenic artery and by endosonographic guided implantation of a lumen apposing metal stent (LAMS). The splenic hematoma was spontaneously regressive without secondary drainage.
Asunto(s)
Pancreatitis Aguda Necrotizante , Choque Hemorrágico , Rotura del Bazo , Femenino , Humanos , Persona de Mediana Edad , Pancreatitis Aguda Necrotizante/diagnóstico , Pancreatitis Aguda Necrotizante/diagnóstico por imagen , Choque Hemorrágico/diagnóstico , Choque Hemorrágico/etiología , Choque Hemorrágico/terapia , Enfermedad Aguda , Stents , Drenaje/métodos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Necrosis , Hematoma/diagnóstico , Hematoma/diagnóstico por imagen , Resultado del TratamientoAsunto(s)
Quistes , Enfermedades del Bazo , Rotura del Bazo , Niño , Humanos , Quistes/complicaciones , Quistes/diagnóstico por imagen , Rotura , Enfermedades del Bazo/diagnóstico por imagen , Enfermedades del Bazo/etiología , Enfermedades del Bazo/cirugía , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiologíaAsunto(s)
Linfoma de Células B Grandes Difuso , Neoplasias del Bazo , Rotura del Bazo , Humanos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Neoplasias del Bazo/complicaciones , Neoplasias del Bazo/diagnóstico por imagen , Neoplasias del Bazo/patologíaRESUMEN
Colonoscopy is a frequently used procedure in our environment for the diagnosis, treatment and even prevention of colorectal cancer. Despite being a routine procedure, it is not exempt from possible complications. Bleeding and perforation are the main ones, with splenic rupture being extremely infrequent as well as one of the most serious complications derived from performing a colonoscopy. We present a patient with splenic rupture secondary to colorectal cancer screening colonoscopy who required urgent surgery for acute hemorrhagic shock.
Asunto(s)
Neoplasias Colorrectales , Rotura del Bazo , Humanos , Detección Precoz del Cáncer/efectos adversos , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiología , Rotura del Bazo/cirugía , Colonoscopía/efectos adversos , Esplenectomía/efectos adversos , Neoplasias Colorrectales/cirugía , Neoplasias Colorrectales/complicacionesRESUMEN
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.
Asunto(s)
Mononucleosis Infecciosa , Rotura del Bazo , Hemorragia/complicaciones , Humanos , Mononucleosis Infecciosa/complicaciones , Rotura Espontánea/complicaciones , Rotura del Bazo/complicaciones , Rotura del Bazo/diagnóstico por imagenRESUMEN
Splenic rupture is the most serious complication of infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV) infection, with a mortality rate of over 1 in 10. We reported a case of spontaneous atraumatic splenic rupture secondary to IM in a young man. The patient presented with abdominal pain caused by splenic rupture as the initial symptom. The diagnosis and treatment process went through a series of twists and turns, including the emergency department, general surgery department, and infection department. This case suggests that clinicians should consider the possibility of EBV infection in young patients with spleen rupture without obvious cause to avoid misdiagnosis and missed diagnosis.
Asunto(s)
Infecciones por Virus de Epstein-Barr , Mononucleosis Infecciosa , Rotura del Bazo , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/diagnóstico , Herpesvirus Humano 4 , Humanos , Mononucleosis Infecciosa/complicaciones , Mononucleosis Infecciosa/diagnóstico , Masculino , Rotura del Bazo/diagnóstico por imagen , Rotura del Bazo/etiologíaRESUMEN
Spleen, due to its unique position and relative mobility, is the most vulnerable organ in blunt abdominal injuries. After splenic trauma, hemodynamically unstable patients are treated with splenectomy. Delayed splenic rupture presents 48 to 72 hours after blunt abdominal trauma and is a rare entity. It is usually associated with low-velocity blunt injuries. The sequela is usually a minor trauma that is concealed initially and presents later as subcapsular hematoma, hemodynamic instability, abdominal pain, and positive Kehr's sign in most cases. Computed tomography is the investigation of choice in such cases. We discuss here a case of delayed splenic rupture that presented after eight weeks of a minor abdominal injury due to a fall. The patient presented with a tender left hypochondrium, positive Kehr's sign, and tachycardia. Computed tomography of the abdomen revealed delayed splenic rupture and hemoperitoneum. As the initial imaging is usually normal in these cases, a routine follow-up and close monitoring of trauma patients can help in the early detection of complications. Key Words: Splenectomy, Splenic rupture, Kehr's sign, Hemoperitoneum.