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Ruptured spleen: an unusual complication of laparoscopy
1Department of Digestive and Thoracic Surgery, Robert Ballanger Hospital, Aulnay Sous Bois, France. elias.habib@wanadoo.fr
Summary
Splenic rupture is a rare complication of laparoscopic surgery. A posterior subcapsular splenic hematoma, undetectable during laparoscopy, can lead to delayed diagnosis and hemorrhagic shock.
Area of Science:
- Surgical Complications
- Minimally Invasive Surgery
Background:
- Splenic rupture is a known complication of open surgery.
- It is significantly less common in laparoscopic procedures.
Purpose of the Study:
- To report a rare case of delayed splenic rupture following laparoscopic surgery.
- To highlight the diagnostic challenges of subcapsular splenic hematomas in laparoscopy.
Main Methods:
- A 45-year-old male underwent laparoscopic surgery for a perforated duodenal ulcer.
- Postoperative recovery was uneventful until readmission due to left upper quadrant pain.
- Diagnosis was confirmed via urgent laparotomy revealing hemoperitoneum from a splenic hematoma.
Main Results:
- The patient developed hemorrhagic shock due to a posterior subcapsular splenic hematoma.
- The hematoma was attributed to the lavage of the left subdiaphragmatic area during laparoscopy.
- This type of splenic hematoma is not detectable during laparoscopic visualization.
Conclusions:
- Delayed splenic rupture is a rare but serious complication of laparoscopy.
- Posterior subcapsular splenic hematomas pose a diagnostic challenge due to their intraoperative undetectability.
- Increased awareness and consideration of splenic injury are crucial in patients presenting with delayed abdominal pain post-laparoscopy.
