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[Spontaneous rupture of a splenic artery]
J Scheele1, S Huttner, L Stettinger
1Abteilung für Allgemein-, Viszeral- und Gefässchirurgie mit Department Kinderchirurgie des Klinikums Kempten-Oberallgäu, Kempten (Allgäu), Deutschland. jscheele@gmx.net
Background:
Hemoperitoneum due to spontaneous rupture of a visceral vessel may result from a variety of underlying pathologies. However, its idiopathic form does not show evidence of any predisposition.
Patient And Methods:
An abdominal CT scan for acute abdominal pain yielded the unexpected diagnosis of a ruptured splenic artery in a 21-year-old patient. Hemostasis was achieved by endovascular coiling of a segmental splenic artery lacking any evidence of pathological transformation. An extensive intraabdominal hematoma was evacuated in a consecutive laparoscopy which, furthermore, confirmed interventional success. Despite extensive diagnostic efforts, the cause of the bleeding remained undefined.
Conclusion:
Spontaneous hemoperitoneum may occasionally be considered as a cause of acute abdomial pain and is diagnostically challenging. An interdisciplinary approach is desirable to meet the objective of modern organ-preserving therapy in splenic artery rupture.
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