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Systematic review of atraumatic splenic rupture
P Renzulli1, A Hostettler, A M Schoepfer
1Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital, and University of Berne, Berne, Switzerland. pietro.renzulli@stgag.ch
The British Journal of Surgery
|September 30, 2009
Summary
Atraumatic splenic rupture (ASR) is often pathological, with neoplastic disorders, splenomegaly, and advanced age increasing mortality risk. Understanding these factors aids in classifying and treating ASR.
Area of Science:
- Medicine
- Pathology
- Surgery
Background:
- Atraumatic splenic rupture (ASR) is a poorly understood clinical condition.
- This study aimed to clarify the causes and risk factors associated with ASR mortality.
Purpose of the Study:
- To characterize etiological factors and risk factors for mortality in atraumatic splenic rupture (ASR).
- To aid in the classification and treatment strategies for ASR.
Main Methods:
- A systematic literature review was conducted from 1980 to 2008.
- Logistic regression analysis was employed to identify risk factors for ASR-related mortality.
Main Results:
- 845 cases of ASR were identified, with 7.0% classified as idiopathic and 93.0% as pathological.
- Neoplastic (30.3%), infectious (27.3%), and inflammatory (20.0%) disorders were the most common pathological causes.
- ASR-related mortality was 12.2%, with splenomegaly, age over 40, and neoplastic disorders significantly associated with increased mortality.
Conclusions:
- ASR can be broadly classified into atraumatic-idiopathic and atraumatic-pathological subtypes.
- Splenomegaly, advanced age, and neoplastic disorders are critical indicators of increased mortality risk in ASR patients.