RESUMEN
Splenic angiosarcoma is a rare neoplasm originating from endothelial cells of the blood vessels. Its incidence is about 0.14-0.25 per million. We report the case of a patient admitted in a state of hypovolaemic shock with haemoperitoneum due to rupture of the spleen. Splenectomy was performed with evacuation of the haemorrhagic effusion. The blood was aspirated and in part instilled during the operation through intraoperative blood salvage due to the large haemoperitoneum. Histological examination revealed a splenic angiosarcoma. Splenic angiosarcoma should be suspected in cases of splenomegaly with unknown anaemia and no lymphoma, leukaemia or myelofibrosis, because of its neoplastic aggressiveness and its invariably fatal outcome. It is important to perform a splenectomy before splenic rupture owing to its negative impact on long-term survival.
Asunto(s)
Hemangiosarcoma/complicaciones , Neoplasias del Bazo/complicaciones , Rotura del Bazo/etiología , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica , Transfusión de Sangre Autóloga , Femenino , Hemangiosarcoma/diagnóstico , Hemangiosarcoma/cirugía , Hemoperitoneo/etiología , Hemoperitoneo/cirugía , Humanos , Pronóstico , Rotura Espontánea , Neoplasias del Bazo/diagnóstico , Neoplasias del Bazo/cirugía , Rotura del Bazo/complicaciones , Rotura del Bazo/diagnóstico , Rotura del Bazo/cirugíaRESUMEN
The article refers to autotransfusion experience in a patient affected by lymphoma (not Hodgkin type), who reached surgery for haemoperitoneum caused by the spontaneous rupture of the spleen. Considering the pathology, this method brought unpredictable variations in the hemochrome thus leading to a deep reflection on the limitations of the use of autotransfusion.
Asunto(s)
Transfusión de Sangre Autóloga , Linfoma no Hodgkin/complicaciones , Rotura del Bazo/terapia , Terapia Combinada , Urgencias Médicas , Hemoperitoneo/etiología , Hemoperitoneo/terapia , Humanos , Cuidados Intraoperatorios , Linfoma no Hodgkin/terapia , Masculino , Persona de Mediana Edad , Rotura Espontánea , Esplenectomía , Rotura del Bazo/etiologíaRESUMEN
The 10-year experience with diagnosis and treatment of closed injuries to the spleen in 84 patients is presented. In 13 patients, the two-instant splenic rupture, in 5--spontaneous was noted. Seventy (83.3%) patients had isolated injuries. In 17 patients, blood reinfusion with total volume of 22,800 ml was performed at operation. Post-operative lethality was 4.8%, total--5.9%. One patient died without operation.