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Splenic hematoma may present as large bowel obstruction: A case report
Christine Kolwitz1, Christopher Esposito1, Caitlin Gauvin2
1Division of Trauma, Bronx, NY, USA.
International Journal of Surgery Case Reports
|January 2, 2019
Summary
A rare cause of large bowel obstruction (LBO) is splenic hematoma, a collection of blood in the spleen. This case highlights successful non-operative management of LBO caused by splenic hematoma following trauma.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Radiology
Background:
- Large bowel obstruction (LBO) is a common surgical emergency.
- Causes are typically intrinsic to the colon, but rare extrinsic causes exist.
- Splenic hematoma as an extrinsic cause of LBO is exceptionally rare.
Purpose of the Study:
- To report a case of large bowel obstruction caused by splenic hematoma.
- To emphasize the potential for non-operative management of this rare condition.
Main Methods:
- A 64-year-old female presented with symptoms of LBO after a fall.
- CT scan revealed a grade 3 splenic hematoma with active extravasation causing extrinsic colonic compression.
- Splenic artery embolization was performed, followed by non-operative LBO management.
Main Results:
- The patient experienced resolution of LBO symptoms and resumed normal bowel function within six days.
- This case, along with a prior report, suggests splenic hematoma can cause reversible LBO.
- Non-operative management was successful in this case.
Conclusions:
- Splenic hematoma should be considered in the differential diagnosis of LBO, especially after trauma.
- Non-operative management is a viable option for LBO secondary to splenic hematoma.
- Increased non-operative splenic trauma management may lead to more splenic hematoma complications.
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