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Ruptured spleen following laparoscopic cholecystectomy
Daniel Leff1, Mei Nortley, Lucy Melly
1Department of General Surgery, Central Middlesex Hospital, London, UK.
Summary
A rare case of splenic rupture occurred less than 28 days after laparoscopic cholecystectomy. This study highlights a potential, albeit uncommon, complication of the procedure, emphasizing the need for vigilance.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Surgery
Background:
- Laparoscopic cholecystectomy is a common and generally safe procedure.
- Complications like bleeding and bile duct injury are known but rare.
- Splenic injury is an exceptionally rare complication, with no prior reports of splenectomy post-cholecystectomy.
Observation:
- A 52-year-old female presented with severe left upper quadrant pain and signs of hypovolemic shock.
- Symptoms appeared 3 weeks after an "uncomplicated" laparoscopic cholecystectomy.
- Clinical findings included localized peritonism and shock.
Findings:
- Abdominal computed tomography confirmed splenic rupture.
- The patient required an emergency splenectomy due to the splenic rupture.
- This represents the first reported case of splenectomy following laparoscopic cholecystectomy.
Implications:
- Splenic injury may rarely complicate laparoscopic cholecystectomy, possibly due to adhesions.
- Consideration of splenic injury in patients presenting with abdominal pain post-laparoscopic cholecystectomy is warranted.
- Intraoperative videoscopic assessment of the spleen could aid early detection and management.
